Step 1: AASMP 2024 Preliminary Membership Application

Step 1: AASMP 2024 Preliminary Membership Application

ENROLLMENT IS NOW CLOSED UNTIL SPRING 2025. COMPLETING THIS FORM ADDS YOU TO THE WAITLIST.
Hey there beautiful momma! Thanks for coming to check out our membership club.

Lots of other amazing women are here and lots great things happening to support you, learn, have fun, and grow. And most importantly, navigate life as a working single mom.

Our club membership enrollment is currently closed until Spring 2025. Completing this application adds you to the waitlist and you will be notified when the application opens.

We will have limited spots available so we can give the proper attention to onboarding new members.

We hope to meet you and have you part of our village.

The next step will be to check your email for a confirmation of this form. Then look for an email to follow STEP 2.

STEP 2: An email with the link to complete the full membership application.

We will be in touch as soon as we review your application. :)
Watch this Message from Founder, Donna Nelson
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
What is the main reason you want to be a member of the Adopt A Single Mom Community?*
What is the #1 thing you will benefit from by being a member?*
If you were referred by a Member, what is her name?
Please include first and last name of the member who referred you
Which NEPA County do you live?
You are working or attending school full time*

Yes
Are you a renewing or past club member?*

YesNo, I have never been a club member
Which membership benefits are you most interested in? Check all that are of interest.*

Monthly Moms Night Out a gathering for social supportMentoring and Emotional SupportSummer Family Fun DayChristmas Gift DriveVolunteeringSocializing and connecting with other single momsAnnual Leadership Brunche-library Expert Education SeriesOther
PLEASE READ ALL THE FINE PRINT...NOT SO FINE PRINT BUT IMPORTANT TO KNOW

Membership application fees submitted to the Adopt a Single Mom Project for membership consideration are a processing fee and non-refundable regardless of the outcome. Application reviews cannot be withdrawn. We may maintain a record of your file for informational, research and future statistical and promotional purposes. No personal indentifiable information is shared, only data.

You will be notified in writing via email with additional information on the next steps in the membership application and process immediately after submitting the preliminary application and processing fee.

Membership applications are accepted only during open periods throughout the year.

By submitting the $10 non-refundable application fee you are agreeing to these terms.

These are the current Membership offerings

You membership commitment is for 1 year. Membership fee can be scheduled on auto-pay and billed for 12 consecutive months or a one-time payment.

Seedling $5/month or $50 Pay in Full Year (virtual only)

Flourishing $10/month or $120 Pay in Full Year
A special part of our membership community is our Pay-it-Forward service model. This means as a member you are required to give back to the AASM Project by either volunteering (10 hours a year) and/or fundraising ($200/yr). Are you able to make this promise? If not, please do not continue the application process.*

Yes
All volunteers complete a Pennsylvania Volunteer level background check.

IT'S FREE AND TAKES ONLY A COUPLE MINUTES TO SUBMIT AND GET A RESPONSE. ONCE COMPLETE YOU WILL HAVE A CONTROL NUMBER WHICH IS A COMBO OF LETTERS AND NUMBERS.

WE NEED YOU TO PROVIDE THE CONTROL NUMBER IN A SECTION BELOW. WE DO NOT WANT YOUR DETAILS FROM A PRIOR BACKGROUND CHECK.

IF YOU PROVIDE A FAKE CONTROL # WE WILL DELETE YOUR APPLICATION AND NOT ISSUE A REFUND.

If you wish to re-submit you will need to complete the preliminary application again and along with the application fee.

TAP HERE TO GO TO THE PSP PA VOLUNTEER BACKGROUND CHECK FORM.

Follow these steps:

1. Choose the top option - tap: NEW VOLUNTEER RECORD CHECK

2. Enter Volunteer Organization Name: Adopt A Single Mom Project

3. Enter Volunteer Organization phone number: 570-762-9913

4. The rest of the information required is your info.

5. Tap through the several SUBMIT steps and do not close your browser while it is processing.

You will receive the results on your screen immediately and receive an email confirmation usually after a couple of minutes to get the R-Control number for the space below of this form.
Provide your first name, last name exactly as you submitted on your PA State Police Criminal Background Check*
Provide your date of birth exactly as you submitted on your PA State Police Criminal Background Check*
Provide the CONTROL NUMBER from your PA State Police Criminal Background Check. *
R control number

Membership Application Fee (non-refundable)*

Membership Application Fee (non-refundable)$10.00

Enter coupon

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

REMINDER:

The next step is to complete the STEP 2 which is the detailed application. It will be emailed and available as soon as you submit this form.

You only have 3 days to complete it otherwise your application automatically closes as incomplete and you will need to resubmit.
If you have any questions before submitting this, please send us an email at adoptasinglemomnepa@gmail.com
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