Home | About Us | News | Newsletter | Meetings | Workshops | Membership | Sponsorship | Listserver | Links | Special Commendations | Comments

Membership Application

Date: ___ /___ / 20__

Name: _______________________________________

Address: _____________________________________
_____________________________________________

Telephone: ___________________________________

E-Mail: _______________________________________

School(s): _____________________________________
______________________________________________

Check all that apply:
" Parent
" Gifted Program Teacher
" Administrator / Supervisor
" Other: _______________________________________

Check areas you are willing to volunteer for:

Thank you for being an advocate for the gifted children and youth of Cobb County. Please share the names and contact info (e-mail or phone) of others in your school(s) who might be interested in making a difference through CC-GAGC:

1. ____________________________________________

2. ____________________________________________

3. ____________________________________________

4. ____________________________________________

Membership Level: (includes membership to GACC)
" Regular ($20/year)
" Sponsor ($50/year)
" Patron ($100/year)

Make checks payable to CC-GAGC (Cobb Chapter of Georgia Association for Gifted Children) and mail to:

CC-GAGC
3600 Dallas Hwy
Suite 230, PMB 260
Marietta, Georgia 30064

Donations include membership in the Cobb Chapter and the State Chapter.)

Membership Application in Microsoft Word format