Application Form

Applications cannot be processed unless all required fields are complete.

Fields in bold are required

Salutation:

First Name:

Last Name:

Middle Initial:

Suffix (Jr. III, etc.):

, ,

Nickname:

Address 1:

Address 2:

Address 3:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Mobile Phone:

Email:

Website:

Company Name (if any):

Position Held:

Check if you currently subscribe to the Piano Technicians Journal

Yes No

Would like your Journal sent by Airmail for an extra fee (International Only)?

Yes No

Indicate past PTG membership status:

Have you ever been convicted of a criminal felony?

Yes No

Birthdate:

(MM/DD/YYYY)

Optional Information

Gender:

Optional Information:

CAUT Contract Technician
CAUT Full-time Technician
CAUT Part-time Technician

I hereby apply for membership in the Piano Technicians Guild (PTG). To the best of my knowledge, all information submitted on this application is correct. By checking this box I acknowledge that I have read the PTG Code of Ethics and I agree to abide by all Bylaws, Regulations, and Codes of the Piano Technicians Guild. By checking this box, I hereby authorize PTG to verify the information I have provided.

I Agree

Chapter - choose one that is in or near where you live or work, If no chapter is indicated, PTG will assign one and send appropriate notifications to the chapter. Chapter numbers relate to the zip code of the chapter seat. Canadian chapter numbers start with 0.

Let the Home Office Pick

Applications cannot be processed unless all required fields are complete.