EmailMe Form - Music Therapy Association for Alberta

Name *

First Last

Phone *

### - ### - ####

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Email *

Membership Category *

I would like the above email address to be used for email notices from MTAA (job referrals, announcements, newsletters). *

Yes

No

I am interested in being involved with MTAA as a volunteer. *

Yes

No

Please note that members of MTAA are required to abide by the CAMT Code of Ethics and Standards of Practice. By checking this box I agree to this statement. *

Yes

No (Please contact us at info@mtaa.ca before proceeding)

MTAs only - I would like my details to be added to the Find a Music Therapist page on www.mtaa.ca.

Yes

No

If Yes, Please indicate how you would like your details to be listed. If there are details you do not wish to share, please leave that field blank.

Name and Credentials

Phone Number

Email

Website

Areas of Expertise

I am currently accepting interns

Please indicate Yes or No or leave blank

City or Town

Listings are by city but you may add additionally cities or include a specific geographical region where you provide services (ex. Southwest Calgary)

Unique ID

Once you have completed this form please make payment. Please select your option of payment and make note of the addresses below:

Electronic Funds Transfer to payments@mtaa.ca

Paypal to payments@mtaa.ca (you must log into your personal paypal account for this option)

Student/Intern rate covered by CE day payment