Membership Form :: Durham Mothers Club

Membership Form

Print ~ Fill Out ~ Mail In.

Initial membership fees are $15 if joining between January 1 and June 30, or a prorated $10 between July 1 and December 31. Membership renewals are $15 and are due every January thereafter.

Mail your dues check (payable to "Durham Mothers Club") and your completed membership form to Kathy Holt, 211 Old Buggy Trail, Hillsborough NC 27278.

Many of us are on vacation during the summer, so please allow longer than two weeks for processing your application. Meanwhile, please feel free to email any officer for more information or to get connected to the group/activity of your choice.

The form has four parts:

1. Personal Data
2. Interests & Involvement
3. Playgroup Placement
4. Resource Requests
PLUS: About your email and your privacy

1. Personal Data:

Date:
Name:
Address:
City/ZIP:
Phone:	( )
	(please include area code)
Email:
	about your email and your privacy »

Name(s) of Child or Children:	Birthdate(s):

(Please give your child's "everyday" name — the one family and friends use.)

2. Interests & Involvement:

Fun for Moms: Would you like to be contacted by any of our special interest groups?
Movie Night (meet other DMC members for a movie)
Book Club (informal book discussion)
Game Night (group games)
Scrapbooking/Crafts

Members' home-based businesses can be listed in our printed directory and on our Member Businesses page. If this is of interest, please list name and description of business, and contact info (website, phone and/or email).

What challenges can we help you meet? (For example: first baby, new sibling, special needs child, finding a preschool, Durham newcomer, etc)

3. Playgroup Placement:

(Leave blank if not applicable)

Which child(ren) would you like to place in a playgroup?

Point of interest nearest to your home (For example: Southpoint Mall, Durham Regional Hospital, South Square, Duke University)

How far (in minutes) would you be willing to drive to meet with a playgroup?

Special playgroup requests? Other questions? (For example: day/time preference, days/times that don’t work for me, playgroup near older sibling's preschool)

4. Resource Requests:

Would you like to request any of our printed resources?
Preschool Directory (profiles of half-day preschool programs)
Parents Morning Out List (List of PMO programs)

Your eMail, Your Privacy

We communicate a great deal by email; that's why we ask for your email address. We as a club do not share our members' personal info, but other people will have access to your email address. If you're concerned about protecting your privacy, you may wish to set up a free email address with Yahoo or MSN/Hotmail.