Become A Friend of Therapeutic Music Application

Date of Application*
MM slash DD slash YYYY
Contact Person Name/Title:*
First Last Title
Organization
Department
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Friend Details
Type of Friend:*
- Organization
- Individual
Type of Organization*
Check all that apply
- Healthcare Provider
- Healthcare Education Provider
- Therapeutic Music Provider
- Therapeutic Music Training Program
- Integrative Therapies Provider
- Other
Please Explain*
Would you like to participate in any projects of the Board?*
- Yes
- No
How are you involved in Therapeutic Music?*
Check all the apply
- Healthcare provider
- I have a therapeutic music program in my facility
- I hope my facility will establish a therapeutic music program
- I want to support therapeutic music
- I am a student or a graduate of a therapeutic music program
- I expect to enter a therapeutic music program
- Other
Please Explain*
The Mission Statement of the NSBTM is to define a body of knowledge, and application of that knowledge, that represents competent practice for therapeutic musicians. In addition, our goal is to create and maintain educational standards for diploma programs and continuing education programs that offer training for therapeutic musicians.
Confirmation of Mission Statement*
- I have read and understand the Mission Statement and I support the work of the NSBTM.
Payment
One Year Membership Fee*
This fee will NOT auto renew
- Membership Fee - $35.00
Optional Tax-deductible Donation
In addition to One Year Membership Fee
Total
$0.00
Method of Payment
We accept payment by Visa, MasterCard, Discover, American Express and PayPal.

When you click submit you will be directed to Paypal to make payment based on the total listed above. After payment is complete you will be redirected back to the NSBTM.org website.

THANK YOU FOR YOUR SUPPORT!!

The National Standards Board for Therapeutic Musicians is a 501c3 Not-For-Profit Organization.
All donations are tax-exempt subject to IRS guidelines.

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Become A Friend of Therapeutic Music Application

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