Tony Leonardi Double Bass Association

Youngstown State University

Est. 2004

Application for Membership

Name_____________________________Phone____________Email________________

Address_________________________________________________________________

City/State/Zip____________________________________________________________

Membership Applying For:       ___Junior (must be enrolled in a K-12 institution; $10 annual dues)

___Collegiate (must be a current YSU student; no dues)

___Community ($20 annual dues)

___Founding ($80 donation; dues waived for five years)

Are you a double bass or electric bass player?                                    How many years have you played?

Who did you study with?                                                                         How did you hear about us?

Comments/Questions:

Ten percent of all money raised (including membership dues) goes toward the Tony Leonardi Scholarship in Jazz.

Become a Founding Member by donating $80.to the Association.  As a founding member you will be listed on the Web site as such and will have your biography and picture on the Web site, as well as contact information and a link to your web site, if you so desire.

Please send completed application

and check or money order to:

Tony Leonardi Double Bass Association

YSU Student Activities Office

One University Plaza

Youngstown, Ohio 44555

Please make checks payable to the Tony Leonardi Double Bass Association