Brown Mama Chapter Interest Form
Hello and thanks for inquiring about building a Brown Mama Chapter in your city. If you are looking to create a positive circle of support for yourself and other African-American mothers in your region, Brown Mamas can provide you with the infrastructure you need to do it! Fill out the form below and someone will be in touch with you in the next 30 days.
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Email address
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Your email
Please list your full name.
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Your answer
Please list your phone number.
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Your answer
What city and state do you live in? Where is the closest metro city?
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Your answer
Do you have a website? If so, please list it.
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Your answer
Why do you want to start a Brown Mama's Chapter?
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Your answer
How many friends do you have that currently want to join?
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Your answer
Please list your Facebook handle.
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Your answer
Please list your Instagram handle.
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Your answer
Please give a brief description of your mothering status. (i.e. single, married, age of children, working status)
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Your answer
Which description best describes your needs. (check all that apply)
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I am a new mom. I need to create a village of support.
I am in the thick of motherhood. I have a supportive family, but I need to make friends.
I have friends and family who are supportive. I want to create something bigger for myself and community.
I am in the thick of motherhood. I need to create a village of support and find my people.
I am looking for opportunities to use my skills and stretch my entrepreneurial muscle.
I am a helper and experienced mother. I'd love the opportunity to help other moms.
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What category best describes you?
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Working Mom
Work-at-Home Mom
Stay-at-Home Mom
Mom Who Works Part-Time
Are you currently a member of any in-person support groups in your city? Please list them.
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Your answer
Please be aware that all information is kept confidential. Please wait 30 days before you reach out to us for an update. We look forward to chatting with you!
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