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Mothers' Center
Membership Form
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the Mothers' Center Membership Form (Adobe Acrobat Document)
Mothers’
Center Membership Form
I want to become a new member (includes a one-year newsletter
subscription)
Member ($25
full year)
Member ($12.50 1/2 year if joining March
– June)
Reduced Rate Member ($10,
being active on a committee and hosting one program per semester is required,
contact Membership)
Add National Mothers’ Center membership
(additional $10)
I want to renew my membership (renewal is in September, $25
full year or $35 total to become a national member or apply for reduced rate
membership be contacting Membership)
Name ______________________
Telephone _______________ E-mail
Address __________________
Address
____________________________________ City/State
_________________ Zip ___________
Your Birth Date (optional)
__________________ (not shared with
members, may be used in general for MC grants)
I would like to be on the
Moms On Call list to help out in the childcare room when needed:
_____ Yes
_____ No
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
_______________________
Spouse’s
Employer_________________________________
Children's Names
Birth Month & Year (MM/YY)
____________________________________________________
____________________________________________________
____________________________________________________
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 & number in order of interest):
____
Childcare
____ Finance
____ Fundraising
____ Hospitality Coordinator
____
Newsletter
____ Programming
____ Secretary
____ Any available position
____
Membership
____ Public Relations ____ Babysitting
Co-op Coordinator
See our website
(www.motherscenterfc.org) for descriptions of the committees or contact one the
committee heads for more information.
Mail
completed form with check made payable to Mothers’ Center to:
Mothers’
Center, Attn: Membership;
1200 South Taft Hill Road
,
Fort Collins
,
CO
80521
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