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Department of Mathematics : PME Application Form

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PME Application Form

Return to the Department of Mathematics, UH 2040, or to Dr. Ivie Stein, Jr., UH 2020C.
Phone Numbers: 419.530.2994 (voice mail), 419.530.2568, and 419.530.2232.
E-mail: Ivie.Stein@utoledo.edu


Name: ____________________________________________________________

(Give your name as it should appear on the certificate.)

Address: _____________________________________________________________

(Permanent mailing address for Pi Mu Epsilon Journal.)

College and Department: ________________________________________________

Year of Graduation: __________ Student ID #: ______________________________

Local address and phone number: _____________________________________

________________________________________________________________

________________________________________________________________

Will this address be the same next year? ___________

E-mail address: ________________________________________________________

For regular and associate membership, an initiation fee of $25.00* is required for the certificate and one year subscription to the journal. Please make checks or money orders payable to Pi Mu Epsilon. Return payment to the Mathematics Department Office, UH 2040. The Pi Mu Epsilon Official Pin is available for an additional $20.00*.

For regular membership (undergraduate and graduate students), please give the following information:

General GPA: _________ GPA in Mathematics: ________

Math courses taken and grades: _______________________________________

________________________________________________________________

________________________________________________________________

*As of February, 2009. Fee schedule is subject to future change.

Generated on: 2009-11-05 15:18 UTC.
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