MUSIC THERAPY ASSOCIATION OF ONTARIO

MTAO, Suite #325, 4936 Yonge St. Toronto, ON M2N 6S3 905-828-0553

WEBSITE: www.uwindsor.ca/mtao

Membership Application

January 2006-December 2006

NAME:______

HOME ADDRESS: (Students: Mail will be sent to your home address unless you request otherwise)

Street/Apt.#:______

City: ______Province: ______Postal Code: ______

Telephone: ______Fax: ______E-mail: ______

WORK ADDRESS: (Students: Please provide your temporary school residence address)

Street/Apt.#:______

City: ______Province: ______Postal Code: ______

Telephone: ______Fax: ______E-mail: ______

Please check correct categories: New Member ( ) Renewal ( )

( ) $55.00 Active Voting I. All individuals with Music Therapist Accredited (MTA) status.

($70.00 after December 15, 2005)

( ) $55.00 Active Voting II. All unaccredited graduates of any CAMT recognized music therapy training program.

($70.00 after December 15, 2005)

( ) $45.00 Active Voting R/I. All retired and inactive, accredited music therapists residing in Ontario.

($60.00 after December 15, 2005)

( ) $25.00 Undergraduate/Graduate Student or Intern. A non-voting membership open to any full time student/intern without MTA status.

Please attach copy of your student card or information describing your internship site with supervisor’s signature.

($40.00 after December 15, 2005)

( ) $40.00 Graduate Student or Intern. A voting membership open to any full time graduate student with MTA status.

($55.00 after December 15, 2005)

( ) $25.00 Associate. A non-voting membership open to any individual not trained in music therapy or any organization interested in music therapy.

($40.00 after December 15, 2005)

Membership includes: free AGM day attendance, access to the “members only” section of the website (includes 4 newsletters per year), and job referrals/information postings via e-mail.

Membership Year:

*Dues are paid for the membership year, January 1- December 31. Credit is not given for dues received part way through the year. If requested, dues received late in the year may be applied to the next year’s membership.