MUSIC LITERACY PROGRAM

PAYMENT

PLEASE NOTE: Teachers should complete only one payment form for all of the students in their studio participating in the Music Literacy Program.

"*" indicates required fields

Date*

Teacher Name*

First Last

Teacher Email*

Phone

Chapter*

Please choose your chapter.
If your chapter is not listed, please contact MLP Chair Melanie Stroud and your chapter president.

Chapter MLP Chair or Contact Email*

Please enter your chapter's MLP contact email here. If you're not sure what it is, look here. If none is listed, use your chapter president's email.

MLP Test Security*

I agree to destroy all MLP tests (digital or physical), or provide them to the chapter chair for destruction, one month after the chapter event date.

I agree

Students Registered*

How many students did you register to participate in your chapter MLP Event? Please do not include MusicLink students.

Total MLP Fees*

Please refer to the information you received from your MLP chair.

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

Card Details

Cardholder Name

Total

Comments

This field is for validation purposes and should be left unchanged.