Membership Application

 

Thank you for your interest in becoming a member of Daniel’s Music Foundation. Membership to the Foundation is available for free to people of all ages with disabilities, both developmental and physical.

Membership Application Form

Which music program(s) would you like to particiate in? 
  Keyboard Voice
  Keyboard II Music Lab
  Rhythm Music Appreciation
 
In addition to the music programs listed above, what additional program(s) would you like us to offer in the future?
  Guitar Song Composition
  Group Jam Other

Do you require any special accomodations?

How did you hear about Daniel's Music Foundation ?

 

Name:    E-mail:

Phone:     Date of birth or age:

Address:

Address:

City: State: Zip:

Disability (optional) :