Member Application

Available Membership Types

New Member, $37
New Member – After November 1st, $25
Renewing Member, $37
Alumni Member, $20
- Must have been a member for 5 years or at least 4 full years and served in a local board position for 1 year.

Requirement for Membership : To be eligible for membership, you must be a parent or legal guardian of multiples or be expecting multiples.

Registration

First Name

Last Name

Street Address

City

Zip

Phone

Email Address

Occupation

Anniversary

Delivering Hospital

Due Date

(If currently expecting)

Are Your Multiples:

Names ages, sex, and birthdates:

If you have any other children, please list their names, ages, sex, and birthdates:

Are your multiples fraternal, identical, don't know?

Do you use social media?

Facebook

Instagram

Twitter

Would you be interested in having meals delivered if you go on bed rest or after the babies have come home?

How did you hear about LCMOM?

May we use photos of your family and their likeness in our advertisements, websites and /or social media postings?

Is your social media handle different than your name?