Specialty Instrument Form

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Texas Music Educators Association

Specialty Instrument
Registration Form
Student Information

Applicant Name: (First, Last)_______________________________________________

Address: _______________________________________________________________

City: ________________________________________ Zip:______________________

Home Phone w/ Area Code _________________________________________________

Age ____________ Gender: _______ Grade: _________________

Instrument: _________________________________________

Applicant Signature: ______________________________________________________

School Information

School: ____________________________________ Principal; ____________________

School Address: __________________________________________________________

City: _________________________________________ Zip: _____________________

School Phone: ______-_____________ School District: __________________________

TMEA Region Number: ___________________

Director Information

Director’s Name: __________________________________ TMEA Number: _________

Email Address: ___________________________________________________________

Directors Signature: _______________________________________________________


Director’s Signature certifies student’s eligibility under TMEA requirements

Return this form along with your recording to TMEA Headquarters, ATTN: Specialty
Instrument, 7900 Centre Park Drive, Austin, TX, 78754 (if sent not using ground
service, use this address: P.O. Box 140465, Austin, TX, 78714).
Postmark must be by December 15 to be eligible.

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