2018-2019 Find Your Fire Registration Form AHUMC MOPS

AHUMC MOPS 2018 - 2019 MEMBERSHIP FORM

Never let the fire go out … When you hope, be joyful. When you suffer, be patient. When you pray, be faithful. Share with God’s people who are in need. Welcome others into your homes. Romans 12:11-13 (NIrV 1998)
Name

First Name Last Name
Phone Number

- Area Code Phone Number

Address

E-mail
YOUR Birthdate (correct year not required)

/ Month / Day Year
Have you attended a MOPS group before?

Yes No
If yes, where?
Have you already registered and paid for the MOPS International membership online at MOPS.org?

Yes No
Home Church (if applicable)
How did you hear about AHUMC MOPS?
Please list your child(ren)'s name(s) and birthdate(s):
Child 1 Name
Child 1 Birthdate

- Month - Day Year
Child 2 Name
Child 2 Birthdate

- Month - Day Year
Child 3 Name
Child 3 Birthdate

- Month - Day Year
Child 4 Name
Child 4 Birthdate

- Month - Day Year
Additional children's names and birthdates
I give AHUMC MOPS permission to use my photo for promotional uses

AHUMC distribution only Meetup Facebook ahumc-mops.org website AHUMC MOPS photo directory, AHUMC MOPS distribution only No photo permisions
I give AHUMC MOPS permission to use my child(ren)'s photo for promotional uses

AHUMC distribution only Meetup Facebook ahumc-mops.org website AHUMC MOPS photo directory, AHUMC MOPS distribution only No photo permissions

AHUMC 2018-2019 Membership dues

2018-2019 AHUMC MOPS Membership dues $ 80.00

I am unable to pay the $80 dues and would like to request a scholarship

I am requesting a scholarship. Please print this form and bring to the meeting.
Should be Empty:

AHUMC MOPS 2018 - 2019 MEMBERSHIP FORM