MOM U ENROLLMENT FORM

Please enter the following information:

	you must have at least one item
Name	you must have at least one item
Address	you must have at least one item
Phone for Text	you must have at least one item
Email	you must have at least one item
Age of Children	you must have at least one item

PLEASE CHECK YOUR INTERESTS: *

	YES	NO
WEEKLY MOMMY MEET UP	YES	NO
BI-MONTHLY FUN OUTINGS	YES	NO
COMMUNITY EVENTS	YES	NO
ENCOURAGING EMAILS	YES	NO
PRAYER CHAIN	YES	NO
QUARTERLY MAGAZINE SUBSCRIPTION	YES	NO

Would you like to order a MOM U t-shirt? If YES, please indicate your size and paypal email for payment.

	you must have at least one item
Size	you must have at least one item
Paypal Email	you must have at least one item