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Name ________________________________________________________________!

! ! !

New Horizons Band REGISTRATION!!

! ! Street ____________________________________________________ Apt. ________! ! ! City _______________________________________ Postal Code ________________! ! ! Phone ___________________________________________ Age _________________! ! ! e-mail contact:" _________________________________________________________! !
No musical experience is required, but if you have done any of the following, indicate the approximate number of years.!

! ______ Piano Lessons ______ Instrumental Lessons in School ! ! ______ Choral Class in School _________ General Music Class in School! ! ______ Guitar Lessons ______ Church Choir ______ Community Band! ! ______ Community Chorus ______ Community Orchestra ______ Other (describe):! ! ___________________________________________________________________! ! Please Indicate Program Time Selection of Choice! !
1. New Horizons Band Exploring Music Music 101a - In the AM 2. New Horizons Band Exploring Music Music 101a - In the PM Return Completed Form /w Cheque Payment payable to: Ennio Paola!! " mail to: Ennio Paola, 275 Senator Street, Pickering, ON, L1V 6N1!" - or -" Bring Completed Form /w Cheque, or Cash Payment to Rehearsal! ! ! ! CARP Active Members: $120.00"

! ! ! !

| Non-Members: $130.00"

CARP MEMBERSHIP & ZOOMER MAGAZINE


Subscribe online at CARP.ca
1 year CARP membership PLUS 1 year (9 issues ) Zoomer magazine 3 year CARP membership PLUS 3 year (27 issues ) Zoomer magazine

ONLY $
TAXES INCLUDED
SH IP+ ME MB ERS CARD REWARD
John Smith

34.95
55-64 Under 55

ONLY $
TAXES INCLUDED

84.95

1 year CARP membership $19.95 1 year Zoomer magazine 9 issues for $19.95 TAXES INCLUDED Mr. Ms. Mrs.
75+ 65-74

PRIMARY MEMBER NAME Age

Mr.

Ms.

Mrs.
75+ 65-74 55-64 Under 55

ASSOCIATE MEMBER NAME Age

ADDRESS

CITY

PROVINCE

POSTAL CODE

TELEPHONE

EMAIL Provide your email, well extend your membership for 1 month at no additional cost.

GIFT RECIPIENT (IF APPLICABLE)


NAME ADDRESS

CITY

PROV

POSTAL CODE

METHOD OF PAYMENT
CREDIT CARD #

Visa

MasterCard

AMEX

Cash

Cheque
EXPIRY DATE

CARDHOLDER NAME

CARDHOLDER SIGNATURE

Choose automatic renewal, and well extend your CARP membership by 2 months at no additional cost. I prefer not to receive special offers by email or ADAD Mail: CARP, P.O. Box 940, Stn Main, Markham, ON L3P 9Z9 Fax: 416.363.8747 or phone: 1.800.363.9736

AMB/CH CODE AMB 16311


GENOF13

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