Mothers’ Center Membership Form

q   I want to become a new member (includes a one-year newsletter subscription)

            q  Member ($12.50 1/2 year if joining March 1st – June 1st)     q  Member ($25 full year)   

   q  Reduced Rate Member ($10 see pg. 19 for details)

q   I want to renew my membership (renewal is in September)

 

Name _________________________  Telephone _____________________  E-mail Address ____________________

Address ________________________________  City/State ________________________  Zip ___________

Please provide the following information so that we may include it on the Membership Roster, which is mailed to all members. 

(this information is kept confidential, and is only shared within the organization)

Spouse’s name ______________________________Your birthdate  ___________________________________

Children's name and birthdates __________________________________________________________________

Where did you hear about the MC?  ____________________________________________________________

 

Every member helps in any way she can at the Mothers’ Center.  It is a wonderful way of meeting other mothers and making new friends.  I am interested in getting information about helping in the following areas (please choose 3 & number in order of interest):

 

____  Childcare     ____   Community Outreach    ____   Finance    ____   Fundraising    ____  Membership

____   Newsletter    ____   Playgroup    ____   Programming    ____   Secretary

 

Mail completed form with check made payable to the Mother’s Center:

The Mothers’ Center, Attn:  Membership; 1200 South Taft Hill Road; Fort Collins, CO  80521