East Coast Jazz Drum and Bugle Corps

MEMBERSHIP INFORMATION  Please print and fill out this form and bring it with you to the Open House.

Please print clearly

Name: ___________________________________________________________________

                        Last                                                                        First       

Home Address

STREET: ________________________________________________________________

CITY: _______________________________________   STATE:_______ ZIP _________

School Address

Street or P.O. Box: _________________________________________________________

City: _________________________________          State: __________       Zip: ________

Date of birth: ___________________ 

Home Tel# (____)__________   Cell# (_____) _________  School Tel. #( ___)___________

E-mail address: _____________________________________________________________

Section of interest: Brass ________      Percussion ________   Colorguard _______

Instrument: _____________________________________________

Marching band or drum corps experience: (Please explain)

Mother’s Name: _______________________________________Tel. (______)______________    

Street: ____________________________________________________ 

            (If same as above leave blank)

City: ______________________________________________   State: ________   Zip: ________

Father’s Name:  _______________________________________ Tel. (______)_______________

Street: ________________________________________________________________________ 

            (If same as above leave blank)

City: ______________________________________________   State: ________   Zip: ________