Accredited Teaching Members – June Clark

June, please create an account on this new WAMTA website by completing the form below.

Please note that this will set up auto-billing for your membership going forward.

You will not be charged at this time. You will have a "free trial" until your membership renews in October, so this form is time sensitive to ensure that your renewal can happen at the correct time.

You will receive a renewal reminder through Stripe 1 month before your renewal falls due, so that you can log in to the website and update your payment details if required.

The members area provides you with the ability to update your billing details.

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Annual WAMTA membership

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First Name *

Last Name *

Email Address *

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Password (type this twice please) *

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Additional Info

Your Personal Details

Date of Birth *

Postal / Home Address *

Phone number *

How did you hear about WAMTA? *

Why have you joined WAMTA? What would you like to get out of your membership? *

Your Teaching Business

Business / Studio Name

Website

Facebook page address

Working With Children Check Notice Number

Working With Children Card Expiry

Teaching Address (if different to Postal Address)

Do you teach online? *
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Do you travel to students' homes to teach? *

Permission to give out your phone number to prospective students? *
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Permission to give out your email address to prospective students? *
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Your Professional Background

Which instrument(s) and/or discipline(s) do you teach? *

What is your highest Performance level completed for each instrument listed? *

What is your highest level of Theory completed? *

Which tertiary-level Music or Music Education qualifications have you completed? *

Have you completed any other Music / Music Education qualifications?

Which year did you start teaching in? *

Do you have any areas of specialisation?

Do you offer other music services (eg accompanying, pedagogy lessons etc)?

Online Listing Details

Bio for website profile

Publish your phone number online? *
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Publish email address online? *
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Billing Method

Credit or debit card

Billing Address

Street Address *

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State / Province *

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