MEMBERSHIP APPLICATION

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Concert Schedule 2011-2012

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Membership Application

Harry Jacobs Chamber Music Society, Inc.

P.O. BOX 15286 AUGUSTA GA 30919-1286 PHONE: 706-790-9274 EMAIL LINK FOR AGENTS & ARTISTS: EMAIL ARTISTIC DIRECTORS

PLEASE PRINT APPLICATION
Membership Subscription Please make check payable to: Harry Jacobs Chamber Music Society and mail to: HJCMS Memberships P.O. Box 15286 Augusta, GA 30919-1286 2011-2012 Season The membership fee is $90 per person for the 2011-12 Concert Season. Membership includes one ticket for each of the six major performances, an invitation to hausmusik concerts, a subscription to the HJCMS e-mail newsletter, and the opportunity to meet world-class musicians. For further information, phone Ruth St. Clair at 706-790-9274 or Email hjcms@comcast.net
Name(s) (as you wish to be listed in the program) ________________________________________________________________________ Mailing Address: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Telephone:______________________________________________ Email Address:__________________________________________
Check enclosed for:
___ Membership(s) at $90.00 each	$___________
___Children’s Membership(s) at $42.00 (Each Children’s Membership includes one ticket to each concert. This is for the convenience of parents who are members to avoid having to wait in line to purchase tickets for children.)	$___________
Tax Deductible Contribution (Much needed for program & Society support) (Receipt upon request)	$___________
Total amount of enclosed check	$___________
Tickets available at the door or from ASU Box Office: Adults (18 years & older): $25.00 School-age children (6 to 18 yrs and currently enrolled): $7.00 Augusta State University students, faculty & staff with valid ASU ID: Admitted free No children under six-years-old admitted.