One moment please...
GEMs (Gracefully Embracing Motherhood) 2023-2024 Membership Form
Mother Information
Name
*
First Name
Last Name
Name Copy
*
First Name
Last Name
Email
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
St. Cecilia Parishioner Member since (Year only)
*
VIRTUS/CMG Safe Haven Trained
*
No
Yes
Children Information
Child 1 - Name and Birth Year
*
Child 2 - Name and Birth Year
Child 3 - Name and Birth Year
Child 4 - Name and Birth Year
Yearly Dues
Amount
*
$30
-
GEMs Membership Dues