Your Name(s)*: 
   Your trade or occupation:     
   Your primary e-mail address*: 
   Your emergency e-mail address:
   Your personal web pages URL:  
   Your Birthday MONTH:    DAY: 

   Your postal address (City and State at a minimum, please!)
      Street:  
      City:    
      State:        Postal Code:  
      Country: 

   Your Daytime Phone:   
   Your Evening Phone:      Your Fax:   

   Your musical children (optional):
     Name:    Birthdate:    Instrument(s): 
     Name:    Birthdate:    Instrument(s): 
     Name:    Birthdate:    Instrument(s): 
     Name:    Birthdate:    Instrument(s): 
     Name:    Birthdate:    Instrument(s): 

   Name of your student's School*:              
   Nickname of your Band, Choir or Orch:        
   URL of your Band, Choir or Orch web pages:   
   Number of students in your Band, Choir or Orch:      
   Number of your children in your Band, Choir or Orch: 

   Name of your booster club:  
   URL of your booster club:   
   Annual Membership Dues Paid by Parent:     
   Annual Music Fee (if any) Paid by Student: 
   Total Annual Fund Raising $ by Parents:    
   Total Annual Fund Raising $ by Students:   
   Two Best Parent Fund Raisers:       
   Two Best Student Fund Raisers:      
   Number of Booster Club members:  
   Number of Active Boosters:       
   
   What special non-fundraising things does your Booster Organization
      do for students?
    
   
   What trips has your organization sponsored?
    

   May we distribute this information to our other list members?* Yes No