2021/2022 Member Registration Form « Fairfield County Chorale

Name(Required)

First Last

Membership Status(Required)

New Member

Returning Member

Voice Part

Date Joined the FCC

Years with the Chorale

Home Phone

Cell Phone(Required)

Birth Month and Day

Rehearsals(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Hidden

Dues Paid

Yes

Waived

Hidden

Vaccination Card

Yes

Hidden

Signed Waiver

Yes

Business Name

Current or Retired from business

Current

Retired

Occupation

Spouse Name

First Last

Spouse Business name & occupation

Does either employer match donations or give grants?

How did you hear about the FCC?

In what other musical organizations do you perform?

Are you a member of a board of any other organization?

For purposes of posting fliers, to what other organizations do you belong? (for example, faith-based organizations)

Are you familiar with any family foundations that would consider supporting the Chorale?

I have a family member or friend who would consider helping on concert nights (selling tickets, ushering, reception, setup, etc...) Name:

Member Registration Form 2021-2022 Season