CCTM Group Rate Form
Beginning with the 2022-2023 school year we are introducing group rates for organizations (e.g, school, district, company). The group rate is $250 and provides an organization with 10 individual member accounts for anyone in the organization and 2 additional member accounts for an administrator and an interventionist supporting mathematics. 

Please complete this form and we will reach out to process payment and set up each person's individual membership account within the CCTM website.

If you have any questions or concerns about the form please reach out to Mary Pittman through email: mpittman@cctmath.org 

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Email *
What is the name of the contact person for this group rate?  *
Please provide contact information and the best possible times of the day to reach out with questions.
 *
What is the name of the organization (e.g., district, school company) applying for a group rate membership? *
In what CCTM region is the organization (e.g., district, school, company) located? *
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Names and Emails
In this section you will need to provide the names and emails for each person that will be included in the group rate. 

You will first provide the name and email of one administrator and one interventionist, both of whom will be provided memberships. These memberships are in addition to the 10 memberships included in group rate. 

You will be able to provide names and emails for up to 10 additional members. You may leave any of the 10 additional member questions blank.
What is name of the administrator that will be included in the group rate membership? *
What is email of the administrator that will be included in the group rate membership? *
What is name of the interventionist that will be included in the group rate membership? *
What is email of the interventionist that will be included in the group rate membership? *
What is name of the 1st of 10 members that will be included in the group rate membership?
What is email of the 1st of 10 members that will be included in the group rate membership?
What is name of the 2nd of 10 members that will be included in the group rate membership?
What is email of the 2nd of 10 members that will be included in the group rate membership?
What is name of the 3rd of 10 members that will be included in the group rate membership?
What is email of the 3rd of 10 members that will be included in the group rate membership?
What is name of the 4th of 10 members that will be included in the group rate membership?
What is email of the 4th of 10 members that will be included in the group rate membership?
What is name of the 5th of 10 members that will be included in the group rate membership?
What is email of the 5th of 10 members that will be included in the group rate membership?
What is name of the 6th of 10 members that will be included in the group rate membership?
What is email of the 6th of 10 members that will be included in the group rate membership?
What is name of the 7th of 10 members that will be included in the group rate membership?
What is email of the 7th of 10 members that will be included in the group rate membership?
What is name of the 8th of 10 members that will be included in the group rate membership?
What is email of the 8th of 10 members that will be included in the group rate membership?
What is name of the 9th of 10 members that will be included in the group rate membership?
What is email of the 9th of 10 members that will be included in the group rate membership?
What is name of the 10th of 10 members that will be included in the group rate membership?
What is email of the 10th of 10 members that will be included in the group rate membership?
Please share anything else you want CCTM to know.
A copy of your responses will be emailed to the address you provided.
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