Motherful Collective Intake Form
Welcome!

Motherful supports, empowers, and nurtures single mothers and their families in Columbus, Ohio by providing resources, community and education. Please fill out our intake form requesting membership in our collective. This is for single mothers or folx who identify as single mothers. You will receive a email once reviewed.
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Email *
Please review a short feature
Full Name *
Pronouns
Gender
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Sexual Orientation
Race
DOB
MM
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DD
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YYYY
Preferred Language
Phone *
Address *
Facebook link
Instagram User name
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Names and ages of your kids
What school district are you in?
What's your single mother story?
What are your Immediate needs *
Required
Please explain briefly about the above question and add anything else.
What do you most like about being a single Mom
If you choose other (#5) Please explain
How did you hear about Motherful?
Why are you looking to join our collective?
What are you special gifts, skills and superpowers?
Our vision is to create a Motherful world in which all mothers and their children are valued, nurtured, supported, and cared for, and where single mothers never again feel alone, abandoned, cast aside, stigmatized or marginalized systemically or personally. We seek to build a safe, intentional community where single mothers joyfully and peacefully work together,, uplift each other, and share an abundance of resources in a collaborative, equitable collective. *
Please agree to review our entire Core Values Statement and Agree or Disagree on each section
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We believe all single mothers are sacred and worthy of support.
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We believe in valuing the work of mothers.
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We believe in an inclusive, representative democracy, which includes: Acknowledging the damages inflicted on Black Americans through enslavement and post-emancipation exclusionary policies. Acknowledging the damages inflicted on Indigenous people through colonialism. Protecting and upholding voting rights. Championing and fighting for Civil rights .Support for reparations.
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We believe in healthcare for all.
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We believe in reparative justice.
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We believe in reproductive justice.
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We believe in justice reform and rehabilitation.
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We believe in LGBTQIA rights.
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We believe in strong public education.
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We believe in equitable economic prosperity for all, which includes: Paid family leave. Equal pay for women and femmes, particularly women of color. Acknowledging and addressing racial inequity Access to affordable housing, childcare and food security. Workforce policies & labor force equity.
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We believe in humanitarian crisis support, which includes: Supporting immigrant & refugee neighbors. Volunteering for local humanitarian aid requests.
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We believe in safe communities and healthy relationships, which includes: Stronger common sense gun laws. Support for survivors of domestic & gun violence. Support for survivors of sexual assault and abuse.
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We believe in upholding disability rights, which includes: Equitable transportation. Equal opportunity to employment and education. Access to affordable health care and Workforce development.
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We believe in a thriving and sustainable environment, which includes: Clean air, water, and parks. Access to outdoor community spaces. Homes free of toxins and poisonous chemicals. Access to affordable and sustainable energy sources.
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Are you interested in living in a single mama village/collective? If you could dream that up what would that look like?
A copy of your responses will be emailed to the address you provided.
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