South Dakota Bandmasters Association

2009-2010 Membership Form

Name (Mr. Mrs. Ms. Dr.)______________________________________________________________

Street Address/PO Box________________________________________________________________

City______________________________ State _____________________ Zip____________________

Home Phone ( ) ___________ - __________________

School or Business Affiliations__________________________________________________________

School or Business Address/PO Box_______________________________________________________

Work City_______________________ Zip_____________ Work Phone ( )________-____________

E-Mail Address____________________________________________________

I teach grades : K 1 2 3 4 5 6 7 8 9 10 11 12 College

(please circle)

Please feel free to give us your input. This is your organization. Your SDBA Board will read all comments.

Comments:___________________________________________________________________________

Please send this form with $25 (checks payable to SDBA) to:

Gary Hansen

2112 West St. Anne

Rapid City, SD  57702

p.s. – Please circulate this information to any interested parties in your school or business

p.p.s. – To be included in the 2009-2010 SDBA directory please return this form and your dues by Christmas.