The Musicians Association of Ventura County

	APPLICATION FOR MEMBERSHIP IN THE UNITED STATES
	American Federation of Musicians of the United States and Canada Local #581
	I, the undersigned, hereby apply for membership in the above stated Local of the American Federal of Musicians of the United States and Canada (AFM). I affirm that all statements made in the application form are true and complete. I agree that, at the option of the Local, I shall forfeit my membership and all monies paid therefore if I deliberately furnish any false information herein
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Last Name First Name Middle Name

Professional Name

Social Security Number

Street Address
City State Zip Code

How long at current address

Previous Address

Telephone: (Home, Principle) (Work, Messages)

Date of Birth:

Place of Birth: (City) (State) (County)

U.S. Citizen? (if not, type of visa)

Closest relative not living with you. Name
Address

Their telephone: (Home, Principal) (Work, Message)

Are you currently an AFM member? (If so, Local Number)

Have you ever been a member of any Local of the AFM and, if so, which Local?

How and when was membership terminated?

Principal Instrument(s):

Other Instrument(s) played:

Are you currently a member of a musical group? What is the name of the group:

Name of any personal manager(s) or booking agent(s) with whom you have any agreements:

Thank you for your application. Upon hitting the "Apply" button below, your information will be routed to our database. A courteous Union Officer will contact you within 24 hours of your submittal. You will also be directed to a page that will allow you to pay your new membership dues on-line safely and securely though PayPal.