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MAEVE Claremont - Registration Form
Welcome to MAEVE Claremont!  We're so happy you found us and excited to get to know you better.

Please fill out the form below to complete your registration.  If you have any questions, please feel free to reach out to our VP of Membership Caroline at claremont--membership@wearemaeve.org.   Please note that registrations are processed monthly near the end of the month or the beginning of the following month.  If you'd like to be added to the chapter right away, reach out to our President, Carolyn Barbera at Claremont@wearemaeve.org.  
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Are you joining as a Home or Affiliate Member?  If you live in Claremont, select "Home."  If you live in a neighboring city like La Verne, Upland or Pomona, select "Affiliate."
First Name *
Last Name *
Email  *
Street Address *
City
State *
Zip Code *
Country
Phone Number *
Racial/ Ethnic/ Cultural Identity *
1st Child's Name
1st Child's Birthday (Month/Year- This is so we can place you in the age appropriate playgroup)
2nd Child's Name
2nd Child's Birthday (Month/Year- This is so we can place you in the age appropriate playgroup)
3rd Child's Name
3rd Child's Birthday (Month/Year- This is so we can place you in the age appropriate playgroup)
4th Child's Name
4th Child's Birthday (Month/Year- This is so we can place you in the age appropriate playgroup)
Additional Children's Names/Birthdays
Are you pregnant or expecting the arrival of a child soon?

This information is only accessible to our chapter leaders to pass along to our Maternal Wellness Chair so they may offer support and resources.
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Why are you interested in joining MAEVE Claremont?

Your answer(s) will help guide our programming priorities and help us learn what our member needs are. 

(Select all that apply)
How did you hear about MAEVE?
Do you agree to abide by the MAEVE Membership Terms? Membership Terms *
Date of Agreement *
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