Math Teachers' Circle Application

Personal Information:

First Name
Last Name
Email:
Home Address
Home Phone #:
School Name
School Address
Work Phone #:
T-shirt Size:

Reference Information:

Reference #1 Full Name:
Reference #1 Institution:
Reference #1 Email:

Reference #2 Full Name:
Reference #2 Institution:
Reference #2 Email:

Statement:

Please prepare a statement explaining why you are interested in participating in the Gold Coast Math Teachers’ Circle and how you would hope to benefit from the program. There are no specific guidelines; simply include enough information to give the reviewers an adequate summary of your reasons for wanting to participate. (Text only please – no graphics or other files.)

Statement: