*   I/We wish to join MANA as an Individual/Joint/Affiliated member

NAME(S) (BLOCK CAPS):-.........................................................................

ADDRESS (BLOCK CAPS):-......................................................................

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Telephone:-

Home...........................................               Work,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Diary............................................               e-mail.........................................

Instrument(s)/voice:-....................................................................................

Please tick as appropriate:-

Please give brief details of performing and/or
other music experience & interests:-

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I heard about MANA from:-....................................................................
Enclosed is a cheque/PO to MANA for

Subscription £ ............     Donation £ ................      TOTAL £ ..................

*    I/We wish to pay by Standing Order and enclose the completed form.

*   (please delete whichever is inapplicable)