Tacoma Parents of Multiples

TPOM MEMBERSHIP APPLICATION FORM

Membership has it's privileges!

Membership with TPOM automatically bestows membership in both National and Northwest Mothers of Twins Clubs.

To apply for a membership to Tacoma Parents of Multiples [TPOM], simply complete the following form. Annual dues are $30 per fiscal year (Sept 1- Aug 31). You may pay for your membership using any major credit card or eCheck after submitting this form.

If you have any questions or would like to register via mail or in person, please don't hesitate to contact us via EMAIL. We look forward to you joining TPOM!

Membership Status (please check one)*:

First Name*

Last Name*

Birthdate*

Mailing Address*

City*

State*

Zip*

Phone*

Email*

Your Occupation

Are you pregnant?

What is your due date?

I/ We are having:

Do yo know the genders?

Spouse's/ Partner's First Name

Spouse's/ Partner's Last Name

Spouse's/ Partner's Birthdate

Spouse's/ Partner's Occupation

Anniversary Date (if applicable)

I/ We have:

Multiples Gender?

Multiple Type

Please list all your children including multiples and other siblings:

Name

Birthdate

Name

Birthdate

Name

Birthdate

Name

Birthdate

Name

Birthdate

Name

Birthdate

In an effort to reach other parents of multiples, it would be helpful to know; how did you hear about TPOM?

Is there a service that you or your spouse/partner could provide to the group (ie: Mary Kay, Financial Consultant, Scrapbooking etc.?) If yes, please indicate in the box below:

Do you have a special talent, ability or skill that could benefit the group? If yes, please indicate in the box below:

In an effort to save on costs, we like to communicate with our members as much as possible online through our member-only community and via email. Please indicate by checking the box below if we may contact you via email.

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