Southern Oregon Birth Connections Annual Membership/Volunteer Form
Name as you would like it to be listed: *
Phone Number: *
Email for the SOBC member mailing list: *
The following questions relate to how your listing will appear in the resource directory
Business Name ( if applicable): * *
Name and Credentials:
Business address you want published in the guide OR a Tagline / Brief description
Website OR Email address
Business Phone Number
Members and Volunteers can make an annual suggested donation of $75 plus $10 each for any additional listings in our Member Directory.
These are the categories to choose where you are listed:
Acupuncturist | Artists and Photographers | Childbirth Educator | Chiropractor | Counselor | Doctors| Detox & Nutrition | Doula | Emotional Support | Fertility and Pre-Conception | Lactation Education and Specialists Midwives | Massage Therapists & Body Workers | Nutrition | Outreach and Activism | Parent and Baby Educators
Placenta Specialists | Therapists | Yoga & Movement Classes
1st Listing Category ( included):
2nd Listing Category ($10 additional)
3rd Listing Category ($10 additional):
Amount enclosed followed by the check number:
Southern Oregon Birth Connections is a volunteer organization. Please make sure you completed this volunteer form to highlight the ways you will help: *
To participate, please send donation via PayPal to, or send check or money order to: Southern Oregon Birth Connections, 1467 Siskiyou Blvd #146 Ashland, OR 97520.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy