Prof. Brent Gibson 
CCTE Executive Secretary 
Dept. of English 
University of Mary Hardin-Baylor
Box 8008
Belton, TX 76513 

Department Membership Form 

Please print this form and mail it to the Executive Secretary. List the names of those who are remitting membership dues to CCTE. A photocopy of your roster will be returned to you as a department receipt. Submitting this department form will assist CCTE to maintain correct and current information.

Applicants for 2000-2001 membership should make check payable to CCTE. The membership year is from September 1 through August 31. Please send your roster to the above address by Nov. 1 so that members will receive mailings from CCTE.

College/University: _____________________________________________________

Address (PO Box/Street, please)___________________________________________

City/State_______________________________(ZIP + four, please)_______________

Dept. Representative: ___________________________Phone____________________

Amount Enclosed:_____________

 

Name: 1. _______________________________  2. _______________________________  3. _______________________________  4. _______________________________  5. _______________________________  6. _______________________________  7. _______________________________  8. _______________________________  9. _______________________________  10. ______________________________

Email address: 1. _______________________________  2. _______________________________  3. _______________________________  4. _______________________________  5. _______________________________  6. _______________________________  7. _______________________________  8. _______________________________  9. _______________________________  10. ______________________________