CCLM Membership Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Membership Options:
Individual Membership: $25
District Membership (good for 5 members per district): $100
Unlimited District Membership (unlimited members per district): $200

Member Benefits:
**access to all of our virtual sessions and recordings for the 2021-22 school year
**3 newsletters throughout the year
**information about important news & events for mathematics leaders in CT.

Please mail payments (Payable to CCLM) to:
CCLM c/o Elise Archibald
135 Amherst St.
New Britain, CT 06053
elisepaone@gmail.com
Please include district/position on subject line.

Email *

Membership Choice

Individual Membership: $25

District Membership (5 members per district): $100

Unlimited District Membership: $200

Clear selection

First Name *

Last Name *

District *

Level *

K-5

6-8

9-12

College

Other

Required

Position *

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Wallingford Public Schools. Report Abuse

Forms