Southern Oregon Birth Connections Annual Membership/Volunteer Form
Name as you would like it to be listed: *
Your answer
Phone Number: *
Your answer
Email for the SOBC member mailing list: *
Your answer
The following questions relate to how your listing will appear in the resource directory
Business Name ( if applicable): * *
Your answer
Name and Credentials:
Your answer
Business address you want published in the guide OR a Tagline / Brief description
Your answer
Website OR Email address
Your answer
Business Phone Number
Your answer
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):
Your answer
2nd Listing Category ($10 additional)
Your answer
3rd Listing Category ($10 additional):
Your answer
Amount enclosed followed by the check number:
Your answer
Southern Oregon Birth Connections is a volunteer organization. Please make sure you completed this volunteer form to highlight the ways you will help: https://goo.gl/forms/Tlr2FeVhU322t4J22 *
Your answer
To participate, please send donation via PayPal to info.sobc@gmail.com, or send check or money order to: Southern Oregon Birth Connections, 1467 Siskiyou Blvd #146 Ashland, OR 97520.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service