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NCTM and Affiliate Membership Order Form

Personalized NCTM/Affiliate membership applications are printed as two-part carbonless forms. The form is designed to allow dues collection with minimum record keeping by any participating Affiliate.

Note: An NCTM membership must be processed on each joint membership application that is sent to NCTM.

These personalized forms are available free of charge through NCTM to Partner Affiliates.

HOW TO ORDER

Step 1. Membership Information

Decide what other Affiliates, if any, that you might want to include on the form. Affiliates are encouraged to collaborate with other Affiliates in your state or region in promoting membership. Indicate in the area below the personalized information that is to be included on the personalized membership forms. Please check all details very carefully.

PART II: Affiliate Membership Information

A. State Affiliate Name: Charter#:

Individual Membership $ for year(s)

Student Membership $ for year (s)

B. Local Affiliate Name: Charter#:

Individual Membership $ for year(s)

Student Membership $ for year (s)

Step 2. Shipping Information

How many copies would you like NCTM to print for your Affiliate?

If your Affiliate is planning to mail these forms, your members/potential members can send their forms directly to NCTM. Return envelopes (addressed and postage paid) are available.

Please indicate the number of return envelopes you would like us to send:

Please allow 30 days for the forms to be printed and shipped.

Date of Request:

Date Forms are needed:

Your Name:

Officer Position Held:

Affiliate Name:

Address:

City:

State/Province:

Zip/Postal Code:

E-mail:

Home Phone:

Fax:

Step 3. Mail completed form to the address below or e-mail all requested information to affiliates@nct.org.

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