If Music be the Food of Love.........................Play On!

Confidential: For Secretary's records only

Surname: __________________________________________________________________________ 

Christian Name or preferred name:_________________________________________________

Date of Birth: __________________

Home Address_____________________________________________________________________

Telephone No. (Home): ____________________

(Office): _______________________

E-mail address ________________________________

Are you: - Employed_________ Retired__________ Other___________

Musical / Educational Qualifications if relevant:

Voice:   Soprano    Alto    Tenor    Bass    Not sure (Please circle)

Membership of other musical organisations past / present:

A)  From_____________  To_______________

                         Organisation__________________________________________________________________

B)  From_____________  To_______________

Organisation_____________________________________________________________________ 

Other relevant information:                        Do you have any health problems?:

                                                                             (For Insurance purposes)