Membership Form

If you would like to talk to someone about our club prior to joining, please contact our membership coordinator.

Name
Street Address
Address (cont'd)
City
State
Zip Code
Best phone to reach you
Email address
Are you a new member?
If you are interested in joining a playgroup, please fill out the information below to help us find a playgroup for you.
Child #1: Name
Birthdate
Gender
Child #2: Name
Birthdate
Gender
Child #3: Name
Birthdate
Gender
Preferred days:
Preferred time:
Preferred age grouping:
Please let us know any other information we should take into account when assigning you to a playgroup (however, please note that we don't typically have enough members looking for a playgroup at any one time to fulfill very specific requests).
Would you be willing to volunteer a few hours of your time to support Mother's Club activities? If so, please specify any skills you have that may benefit the club (guest speaking, baking, accounting skills, etc.).
Thanks for completing this form! To activate your membership, we must receive your $10 membership fee. Payment can be made by PayPal or check. After hitting the submit button, you will be taken to a page that will give you information on how to pay using your preferred method of payment. If you are not automatically redirected to PayPal after submitting your form, please copy and paste this link into your browser - http://www.smalllinks.com/15MI.
What is your preferred method of payment?
If you plan to pay by PayPal, please let us know what email address you use for your PayPal account.