KMEA All-State Band Audition Fee Report - Kentucky Music

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					                     KMEA All-State Band Audition Fee Report
Please use this form to report the number of auditions in your district and include payment
equal to the number of auditionees at $3.00 each. Send a copy of this form and payment
(no cash) directly to the KMEA office. Send another copy to the State Band Chair and keep
a third copy for your records.


                                                  Please send completed for and payment to:

                                                      Kentucky Music Educators Association
                                                                P.O. Box 1058
                                                        Richmond, Kentucky 40476-1058




Name                                                     District

Address                                                  City                    Zip

Phone                              Email

School

Address                                                  City                    Zip

Phone



Number of students participating        x $3.00    =

                  Total payment to be sent to KMEA



                  Mastercard    Visa       Discover       Check (made payable to KMEA)

Name on card                                           Card number

Expiration date                V-code                  Signature




    Please return this form and payment to KMEA within five (5) days after the audition.
Please return this form and payment to KMEA within five (5) days after the audition.

				
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