American Guild of Organists
Central Florida Chapter
2016-2017 Membership Form
It is now time to renew your membership for the 2016-2017 year. Your dues include a one-year subscription to The American Organist Magazine (TAO) and support for the programs run by the national organization and by our local chapter. To continue receiving the benefits of membership and your TAO subscription, please mail your dues payment now to:
Make Checks Payable to: Central Florida AGO 
Mail to:
     Ken Stoops
     186 Underhill Loop Dr.
     Orlando FL 32825
Membership Renewal
New Member Application
    
Name
______________________________ ________________________
 
e-mail Address
Address
______________________________ ________________________ _____ __________
Street
City State Zip
______________________________ ________________________
Telephone
FAX
Job Title ______________________________
Church or Business:
Name
______________________________   ________________________
Work e-mail Address
Address
______________________________ ________________________ _____ __________
Street
City State Zip
______________________________ ________________________
Telephone
 
FAX
Do you teach organ?            Yes     No
If you select any category in Voting Membership and are available to substitute, indicate those that apply:
Chapter Supply:
 Worship Services     Weddings     Funerals
Membership Category
(check one)
Amount Due
Amount
Paid
Voting Membership
Regular
$100.00
$_________
Special
$75.00
$_________
     
(Over 65, under 21 or disabled)
Student
$40.00
$_________
(Full-time with valid school I.D.)
Partner
(2nd member at same address, no TAO)
    2nd Member
$75.00
$_________
Dual
$39.00
$_________
(Paid to 2nd Chapter)
Primary Chapter___________________
Student Dual Member
$13.00
$_________
Non-Voting Membership
Chapter Friend (no TAO)
$40.00
$_________
Tax Deductible CFAGO Scholarship Fund $_________

TOTAL AMOUNT ENCLOSED
$_________
Please check areas of expertise
 
O = Organist
 
A = Associate or Assistant
 
C = Director
 
H – Handbells
 
Fl – Flutist
 
V – Vocalist
Please check your correct AGO certification, if any
 
FAGO = Fellow
 
AAGO = Associate
 
CAGO = Colleague
 
ChM = Choirmaster
 
SVPlC = Service Playing Certificate
Signature____________________________________________Date____________________
By signing this form, you agree to abide by the Code of Ethics of the American Guild of Organists.
Please complete the AGO Sign Up Sheet HERE. and mail the form with your membership application.