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SOFY Single Mom's Support Registration Form
Welcome, Moms
Please fill out this short form to register for support. All information is kept confidential and will be used to connect you with the right resources.
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* Indicates required question
Email
*
Your answer
Mother's Name
*
Your answer
Mother`s Age
*
Your answer
How Many Child/Children do you have?
*
Your answer
Child/Children Name
(If you have more than 1 child, separate the names with a comma e.g. John Kamau, Cindy Achieng, Calm Mueni)
*
Your answer
Child/Children's Age
( If you have more than one child, separate their ages, with a comma e.g. 6, 12, 14)
*
Your answer
Country
*
Your answer
State/City
*
Your answer
Phone Number
*
Your answer
Support needed
*
Therapy & Counseling
Business Mastery Training
Child Education Support
Prayers and encouragement
Go back to school / continue my education
Other:
Describe your most pressing issue and anything else you might want to share (Optional)
Your answer
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