EuroCass Membership Application Form

Please fill out this form in its entirety.

Last Name:         

First Name:        

Address:           

Address2:          

City:              

State/Province:    

Zip/Postal Code::  

Country:           

Phone:             

Which instrument do you play?

Are you professionel or a amateur?

If professionel please choose an item?

Your E-Mail Address:

Membership Rates (for Western Europe): Individual full membership: 10 Student membership: 5

Please wait with payment until you recieve our information!