CAPT-ACAP Communication (all submissions remain confidential within the CAPT; please check only applicable information, *Asterisk ... required information, Contact information is requested for 3 month trial at PianoTuning.com)
Title (Mr. Mrs. Ms.)
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First Name
*
Last Name
*
Business Name (optional)
Street Address / P.O.Box etc.
*
City
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Province / State
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Postal Code / Zip
*
Country
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Phone # with area code
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Mobile Phone # (optional)
Email Address (Please provide preferred email address for PianoTu.ning discussions if applicable)
*
Re-enter email address
*
(OPTIONAL) Your Website Address
(1) MEMBER: I have paid my 2012 CAPT membership dues.
*
Yes
No
(1) MEMBER: Retired CAPT member?
Yes
No
(1) MEMBER: My contact information has changed or is incorrect (please submit updated information)
Yes
No
(1) MEMBER: I am requesting CAPT Community Forum access (included with CAPT membership...select NO if already registered)
Yes
No
(1) I am a CAPT member and require a password for CAPT member resources.
Yes
No
(2) NON-MEMBER: I am registering for 3 month CAPT Community Forum trial at PianoTu.Ning.com (Contact information is required for follow-up by CAPT Administrators)
Yes
No
(2) NON-MEMBER: My citizenship is Canadian.
Yes
No
(OPTIONAL) ... Musical Experience? (pianist or other)
(OPTIONAL) Professional in another music-related industry?
Yes
No
(OPTIONAL) Employed (Full Time) with a Piano Manufacturer, Distributor, Dealer? (Yes/No ...Detail)
Piano Service Experience (0 ... but interested in piano technology)
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Yes
No
Piano Service Experience (less than 5 years)
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Yes
No
Piano Service Experience (more than 5 years)
*
Yes
No
Also a member of another Piano Tech organization?
Yes
No
Name of other tech. organization(s) - (optional)
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