AMS/MAA/MSRI/NAM/NCTM
Mathematics/Mathematics Education
Interest Data Collection Form
 
Further information on this project

To update an existing form at any time, please contact the AMS rather than submitting a new form. The AMS will stay in contact with each submitter to update information annually.

Contact Information: This information will not be publicly displayed on the internet. It may be given out by participating societies to conference organizers or for data collection purposes.  Fields with an asterisk require input.
*Last Name
*First Name
Middle Name
Title
Address line one
Address line two
Address line three
City
State
Zip Code (USA)
Phone with area code
Email
Choose one:     Yes, conference organizers may invite me via e-mail
You may use my e-mail for administrative purposes only; do not give it out

Education/Affiliations

Highest Degree Earned:

Field of Highest Degree Mathematics Mathematics Education
Other, please specify:

Occupational title
Institution where employed

If employed in academia:
Department

If working in the field of mathematics education: Check as many grade levels of interest as apply:
Pre-K-Grade 2 Grades 3-5 Grades 6-8 Grades 9-12
community college undergraduate graduate

Professional society memberships:
AMS AWM MAA NAM NCTM SIAM
Select all that apply

Personal Information

Gender: Female Male
Citizenship:

Race/Ethnicity
African American
Chicano/a, Latino/a, Hispanic American
Native American, Native Alaskan, or other indigenous people of the Americas
Native Hawaiian
Other: please specify   

Fields of Interest

Please list one or more mathematical areas of interest. There is a list of fields below for reference.

Enter as many 2-digit codes separated by commas as you like. Please note Mathematics Education is Mathematics Subect Classification number 97.

Graduate Students: Please complete the following. Others submit form below.

 

Year you began graduate study (please use four digits)

Year you intend to complete degree program (please use four digits)
Current degree goal
 Master's Doctorate
Other    
Current degree field
 Mathematics Math Education
Other    
If your current degree goal is a Master's, do you intend someday to continue into a Doctoral program?
 Yes     No
Current status

Full time     Part time

 
If you view someone as a particularly important mentor for your achieving your goals in your field, please write that person's name here

A printable pdf version of this form is available for submiting form by mail.

If you need further information about this form and the database, or to change your data at any time, contact the AMS at 800-321-4267, ext. 4105, or write to Professional Services Department, AMS, at prof-serv@ams.org, or at this mailing address:

Professional Services Department
American Mathematical Society
P.O. Box 6248
Providence RI 02940

Policy questions about the database should be directed to Robert Megginson, meggin@math.lsa.umich.edu.