REGISTRATION FORM

Historical Harp Society -- Membership -- 2007


Name: ____________________________________________________________

Address: __________________________________________________________

City: ____________________________ State / Province:______  Zip: __________

Country: _____________________________ Other Postal Code:: _____________

Phone: ____________________________  Work Phone: ____________________

E-mail: ___________________________________________________________

Cell Phone: _________________________  Fax: __________________________

Check as appropriate below:
□    New member            □    Returning member

My special interests are in the harps and music of:
□    The Middle Ages
□    The Renaissance
□    The Baroque
□    The eighteenth century
□    The nineteenth or twentieth century
□    Latin America
□    Other (explain):
□    Ireland
□    Scotland
□    Wales
□    Africa
□    The Middle East
□    The Far East

I am a: (check or circle as appropriate)
□    Harp teacher: private  /  academic  /  both
□    Student: beginning  /  intermediate  /  advanced
□    Performer: amateur  /  professional
□    Harpmaker: historical  /  folk  /  lever  /  modern pedal
□    Musicologist
□    Other (explain):

I own the following harp(s): (please indicate maker, size, style, and other unique features)
□    Historical
□    Folk
□    Other

Please create an entry for me on the HHS web site, with my name, address, phone, e-mail,
    and web site URL or up-to-30-word business blurb.
□    Web site URL:
□    Other contact information (30-word limit)
TOTAL                                                                                                    $ ____

Please send this form with a check payable to "Historical Harp Society"
to our registrar.
Checks should be mailed to our new membership address:

Historical Harp Society
P.O. Box 662
Havertown, PA 19083-0662

  Edith Dersch (HHSTreas@yahoo.com)

Questions: BigHarper@aol.com or president Cheryl Fulton, at harpnhorse@sonic.net .

(Use your browser File/Print menu option to print this page,                       
then fill it out and mail it to the registrar with appropriate payment.          
If the page doesn't fit, copy and paste to your word processor for editing.)

(form revised April 6, 2008)