2019 - 2020 GMOM Membership Form
Thank you for your interest in becoming a member of GMOM! Whether you're a new member or a returning member, we're happy to have you! Remember that your membership is not complete until GMOM has received your completed membership form and your membership dues. Please take a few moments to fill out this brief form for our records, and check your inbox for a welcome email from GMOM. Note that questions marked with a red star are required.
Email address *
Are you a New Member or a Renewing Member *
For New Members: How did you hear about GMOM? If someone referred you to GMOM, please let us know their name!
Your answer
First Name *
Your answer
Last Name *
Your answer
Name on Facebook (if different from above)
Your answer
Date of Birth *
MM
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DD
/
YYYY
Address *
Your answer
Phone Number(s) *
Your answer
Do you have, or are expecting, Twins, Triplets, or Higher Order Multiples? *
Multiple's Names, Genders, & Birthday (mm/dd/yyyy). If expecting, please let us know gender(s) and due date. *
Your answer
Other childrens' names, genders, & birthdays (mm/dd/yyyy).
Your answer
OPTIONAL: Would you like to be a Mentor Mom*, OR, if you are a new or expectant mom, would you like to be connected with a Mentor Mom?
*MENTOR MOM: A 'been there, recently done that' mom who is willing to offer moral and emotional support mothers of younger twins/triplets.
If you answered Yes - I would love to be a Mentor Mom, please list areas/topics you would feel comfortable in offering support (ex. breast feeding, c-section recovery, organization, parenting singletons after/before twins, special needs, potty training, school, etc)
Your answer
Photos taken at GMOM Sponsored Events of me or my children may be posted to the GMOM Facebook page and GMOM Website for marketing purposes. *
Membership dues are $31 for the club year (club year runs Aug - July).** Your membership is not valid until dues are paid. Membership Dues may be paid via Check or PayPal. Please click the following link to pay your dues via PayPal: paypal.me/GMOMmembership2017/31
** GMOM has the option to sponsor a limited number of full and partial memberships on an annual basis. Sponsorships are awarded based on availability, need, interest, and household income. If you feel you may qualify for a GMOM Sponsored Membership, please contact Nicole Arslan at gmom.president@gmail.com.
A copy of your responses will be emailed to the address you provided.
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