Cocoon Club Adult Membership Form

Cocoon Club Adult Membership Form

Thank you for your interest in joining our Cocoon Club community! Membership is free for our nonprofit and school partners and women who volunteer with Butterfly Dreamz. There is a one-time fee of $100 for other adult women. Our membership fees help us cover the costs of maintaining our community app and creating valuable tools and resources for our members. After you submit this membership form, you will receive a welcome email with instructions on how to download our community app, Mobilize. If you do not receive this email within 5 minutes, please contact us at info@butterflydreamz.org. We look forward to having you in the club!!
Name*

First NameLast Name
Email*
example@example.com
Which Cocoon Club membership would you like?*
prevnext( X )
Volunteers & Partners- Nonprofit partners, school partners, and Butterfly Dreamz volunteers
$ Free

Women Mentor Membership- Adult women who mentor, teach, and/or provide care for teen girls.
$100.00

Total

$0.00
What city do you currently live in?*

Gary, INChicago, ILNewark, NJNew York, NYOther
Are you a participant in any of our partner programs?*

Cleveland Elementary School (Newark, NJ)West Side High School (Gary, IN)The Breedlove Readers (Syracuse, NY)Project sWish (Chicago, IL)None of the above
What do you hope to gain from joining the Cocoon Club? Select all that apply.*

Connecting with other women and girl leaders.Being a mentor to teen girls and young women.Learning about college and career opportunities.Growing my leadership skills.Volunteering in my community.Not sure.Other
To learn more about how we can increase diversity in our community, we invite you to voluntarily provide the following demographic information at the end of this form.
Which best describes your race/ethnicity?*

AsianBlack or African AmericanHispanic or LatinxNative American or American IndianNative Hawaiian or Other Pacific IslanderWhitePrefer Not to SayOther
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