Bowling Green Council of Teachers of Mathematics (BGCTM) Membership Form
NOTE: Memberships run fall/spring/summer for those paying in the fall and spring/summer/fall for those paying in the spring.

**Your membership is good for one year from the first day of classes in the semester you join.**

UPON COMPLETION OF THIS FORM, PLEASE FILL OUT THE MEMBERSHIP APPLICATION FORM ON THE BGCTM WEBSITE AT www.bgsu.edu/bgctm AND TURN IT IN WITH YOUR $15.00 MEMBERSHIP FEE ONLINE USING THE LINK SAYING "ONLINE MEMBERSHIP PAYMENT LINK" THAT IS ALSO ON THE BGCTM WEBSITE.

Please direct all questions and concerns to Rebecca Johnson at rebcjoh@bgsu.edu.
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First Name *
Last Name *
Primary Email Address (@bgsu.edu) *
BGSU ID Number *
Is this a new membership or renewal of your membership? *
Major *
Year *
Current Semester (Fall/Spring & Year) *
Expected Graduation Date (Month/ Year: ex. Spring 2025 would be May 2025) *
Primary Education Courses Professor or Advisor (example: Dr. Gabriel Matney) *
E-mail of Professor or Advisor (example: gmatney@bgsu.edu) *
Permanent Mailing Address (Street Name & Number) *
Mailing Address City *
Mailing Address County *
Mailing Address State *
Mailing Address Zip Code *
Home or Cell Phone Number *
Local Address (BG Address) (Street Name & Number) *
Local City, State *
Local Zip Code *
Grade Level(s) of Interest (Check all that apply.) *
Required
OCTM Interests (Check all that apply.)  You may be contacted by OCTM leaders later as a follow up.  No commitments necessary!  We want to engage you in ways that you choose to be engaged. *
Required
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