Member Intake Form
Single Dads United is a community built for Single Dads who are navigating the journey of parenthood with strength, love, and resilience. Whether you're seeking support, resources, mentorship, or simply a place to connect with others who understand your experience, you’ve come to the right place. This intake form helps us get to know you better so we can tailor our programs, services, and outreach to meet your needs. Your information will remain confidential and will only be used to support you and provide you the resources you need.
Full Name
*
First Name
Last Name
E-mail
*
The best email to follow up with you
Phone Number (Best number to reach you)
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which is important to help you in your parenting journey? "Select all that apply"
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Legal Consultation (custody, child support, etc.
Financial assistance (e.g., scholarships, grants)
Career Development Assistance
Childcare Resources
Coaching Services (e.g., mental health and emotional support)
Community events and networking
Other
Number of children 17 and under
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1 child
2-3 children
4 or more children
Name
First Name
Last Name
How can we help you?
How did you hear about us?
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I understand that Membership is free and is exclusively open to Single Dads and their children. By joining, I affirm that I meet this eligibility and am committed to engaging respectfully and positively within the community.
Yes
Submit
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