La Crescent Mops Registration Form 2009
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La Crescent MOPS Registration Form 2009-2010
Full Name:__________________________________________________
Birthday: ______________________
Address:_______________________________________ City: _______________________ State:___________ Phone:______________________________________ Email Address: __________________________________ Do you attend a church?
Yes No
If so, where? _____________________________________________
Have you attended a MOPS group before?
Yes
No
If so, where? ________________________
How did you hear about this MOPS group? ____________________________________________________ Would you be interested in attending an evening MOPS (no childcare provided)?
Yes
May we publish your name, phone, & e-mail in our MOPS group mom’s directory?
No Yes
No
Registration and Session Fees Please Note: MOPS International requires all moms to be registered members. With your paid registration you’ll receive by mail, the MOPS International Membership packet, the bi-monthly “Momsense” magazine and our theme book, “Life on Planet Mom”. Fee Breakdown and Payment Plans $23.95 MOPS International Fee ($21.95 if paid before May 30, 2009). Register early! $3/ per session fee, without enrolling your children in MOPPETS ($45 /2009-2010) $5/per session fee (total) when enrolling any number of children in MOPPETS ($75 /2009-2010) We will be meeting for 15 sessions. Semester 1 begins October 8, 2009; Semester 2 begins January 7, 2010. Option 1 – Pay by session __Pay MOPS Intl. Fee __Then pay by session attended
Option 2 - Pay by semester __Pay MOPS Intl. fee when registering __Pay $22.50 for each Semester, no MOPPETS __Pay $37.50 for each Semester, with MOPPETS Semester 1 Payment Due October 22. Semester 2 Payment Due January 21.
Option 3 – Pay for entire year __ Pay MOPS Intl. Fee when registering __ Pay $45 for year, no MOPPETS __ Pay $75 for year, with children in MOPPETS
Yes, I want to donate to help other moms pay their fees. $_________
Scholarships are available .It is our desire to see that all women have the opportunity to participate in MOPS.
Make checks payable to LEFC, and write MOPS in the memo section. Mail this form & your MOPS Int’l. membership fee to: LEFC 1675 County Road 6 La Crescent MN 55947
Full Name:__________________________________________________
Birthday: ______________________
Address:_______________________________________ City: _______________________ State:___________ Phone:______________________________________ Email Address: __________________________________ Do you attend a church?
Yes No
If so, where? _____________________________________________
Have you attended a MOPS group before?
Yes
No
If so, where? ________________________
How did you hear about this MOPS group? ____________________________________________________ Would you be interested in attending an evening MOPS (no childcare provided)?
Yes
May we publish your name, phone, & e-mail in our MOPS group mom’s directory?
No Yes
No
Registration and Session Fees Please Note: MOPS International requires all moms to be registered members. With your paid registration you’ll receive by mail, the MOPS International Membership packet, the bi-monthly “Momsense” magazine and our theme book, “Life on Planet Mom”. Fee Breakdown and Payment Plans $23.95 MOPS International Fee ($21.95 if paid before May 30, 2009). Register early! $3/ per session fee, without enrolling your children in MOPPETS ($45 /2009-2010) $5/per session fee (total) when enrolling any number of children in MOPPETS ($75 /2009-2010) We will be meeting for 15 sessions. Semester 1 begins October 8, 2009; Semester 2 begins January 7, 2010. Option 1 – Pay by session __Pay MOPS Intl. Fee __Then pay by session attended
Option 2 - Pay by semester __Pay MOPS Intl. fee when registering __Pay $22.50 for each Semester, no MOPPETS __Pay $37.50 for each Semester, with MOPPETS Semester 1 Payment Due October 22. Semester 2 Payment Due January 21.
Option 3 – Pay for entire year __ Pay MOPS Intl. Fee when registering __ Pay $45 for year, no MOPPETS __ Pay $75 for year, with children in MOPPETS
Yes, I want to donate to help other moms pay their fees. $_________
Scholarships are available .It is our desire to see that all women have the opportunity to participate in MOPS.
Make checks payable to LEFC, and write MOPS in the memo section. Mail this form & your MOPS Int’l. membership fee to: LEFC 1675 County Road 6 La Crescent MN 55947
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