Musical Instrument Technicians Association

MITA Membership Application

Please fill out form, then print it, and mail it to the treasurer, as listed at the end of the form.

Member Name:

Company Name:

Address Ship:

Address Mail:

City:

State:

ZIP:

Country:

Business Phone:

FAX Phone:

Home Phone:

Toll Free Phone:

Mobile Phone:

eMail for Public WebSite Membership Listing:

eAddress for Private MITA_Forum Subscription:

Web Address:

Add extra info and comments below (max; 5 lines of 45 characters each)

Enclose a $150 Check or Money order paid to M.I.T.A., Int'l

And Mail it to:

c/o Fran Hellmann, Treasurer, MITA Intl.
376 Old Woodbury Rd.
Southbury, CT 05488

New! Pay by Charge Card

Downloaf the pdf Charge Card Payment Form

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