MOPS of Northbrook UMC Registration
  

We are not offering online registration at this time, but we are accepting registrations for the 2011-2012 year! Please print the registration form and mail it to the MOPS Finance Team Leader, Darcy Austin darcy.austin@gmail.com, 828-551-9930, or turn it in at the Northbrook office.

Please be sure to read our fee schedule.

Name:

Address:

City:

Zip:

Home
Phone:

Cell/Other
Phone:

Email:

Years in MOPS:

Husband's
Name:

Anniversary:

Church
Affiliation:

Birthday:

How did you hear about MOPS?   

May MOPS publish your information in the MOPS Directory? Yes No

I have read, printed, and will mail the MOPS Fee Schedule:
(make checks payable to MOPS of Northbrook UMC).

Split payment option - $75 Sept/$75 Jan

I need financial assistance:

 


List the names and birth dates of all your children. Indicate the ones you plan to enroll in MOPS child care.

Child's Name:

Date of Birth:

Enroll in Childcare?
Yes No

Child's Name:

Date of Birth:

Enroll in Childcare?
Yes No

Child's Name:

Date of Birth:

Enroll in Childcare?
Yes No

Child's Name:

Date of Birth:

Enroll in Childcare?
Yes No

Child's Name:

Date of Birth:

Enroll in Childcare?
Yes No

Service Opportunities

The MOPS leadership team provides a special opportunity for service and growth. Make your MOPS experience even more rewarding by getting involved! Please check any areas where you might like to serve:

  MOPPETS Child Care Team

  Discussion Group Facilitator

 


Please contact:


Jen Allen
404-372-4423
mygreenthumbs@gmail.com

Tiffany Howard
404-822-7661
tlctarheel@yahoo.com