Membership Form
LISFA MEMBERSHIP APPLICATION
Name: ____________________________________
Home Address: _____________________________
__________________________________________
Home Phone ( ) ________________________
E-Mail Address ____________________________
School District _________________ School Phone ____________
School Building(s) _______________________________
Major Instrument ________________________________
DUES: $20.00
Please make checks payable to “LISFA” and send to:
Maureen Jenness
227 Vineyard Rd.
Huntington Bay, NY 11743