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Wednesday, 10 March 2010
 
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Registration
Thank you for your interest in the Saddleback Mothers of Multiples Club. Please take a moment to share some information about yourself with us. Please note that this information is kept strictly for internal use. Contact and Family information is only visible to certain, approved, Board Members. If you are, or choose to become, a Member, your mailing address will be shared with the National Organization Mothers of Twins Club for the purpose of newsletter distribution. If you opt-in to our Member Directory, your name, city, phone numbers, type of multiples and their birth date will be visible to other members. You will also have a forum profile that will allow you to include other information visible to registered members. Other than that, we will not share or sell your information with anyone. If you are registering as a Prospective Member, your details will be verified by telephone prior to your registration approval.
First Name: * This Field is required This Field IS visible on profile
Last Name: * This Field is required This Field IS visible on profile
Username: * This Field is required This Field IS NOT visible on profile Information for: Username: : Please enter a valid User Name. No spaces, more than 2 characters and contain 0-9,a-z,A-Z
 
E-mail: * This Field is required This Field IS NOT visible on profile Information for: E-mail: : Please enter a valid e-mail address.
Password: * This Field is required This Field IS NOT visible on profile Information for: Password: : Please enter a valid Password. No spaces, more than 6 characters and contain 0-9,a-z,A-Z
Verify Password: * This Field is required This Field IS NOT visible on profile
Your Birthday: This Field IS visible on profile Information for: Your Birthday : Please include your Birthday. If you are under the age of 13, we must have on file your parents written permission for you to register. This is in compliance with the Child Online Privacy and Protection Act. You will be recognized in the Newsletter in the month of your birthday. To Scroll through the years, click on either the << or >> buttons. To scroll through the months, click on the < or > buttons.
Please Hide My Age: This Field IS NOT visible on profile Information for: Please Hide My Age : Please check this box if you do not want to include your age on the birthday banner.
Street Address: * This Field is required This Field IS visible on profile Information for: Street Address : Please enter your Street Address
City: * This Field is required This Field IS visible on profile
State: * This Field is required This Field IS visible on profile Information for: State : State
Zip Code: * This Field is required This Field IS visible on profile Information for: Zip Code : Zip Code
Contact Preference: * This Field is required This Field IS visible on profile Information for: Contact Preference : If you are requesting registration as a Prospective Member, we like to make personal contact with you to find out how you're doing and to learn more about you. Do you have a preference of how we contact you?
Phone Number: * This Field is required This Field IS visible on profile Information for: Phone Number : XXX-XXX-XXXX Please provide your phone number. You will be contacted by phone at least once by a club member prior to account activation.
Mobile Phone: This Field IS visible on profile Information for: Mobile Phone : XXX-XXX-XXXX Please enter your mobile phone number
Additional Info: This Field IS visible on profile Information for: Additional Info : Please tell us about any issues or complications you had during your pregnancy, or after birth. If there is anything else you'd like to share to help us get to know you, do it here.
Include in Member Directory?: * This Field is required This Field IS visible on profile Information for: Include in Member Directory? : Do you want basic contact information made available to SMOMC Members? The information in the directory includes: Name, City, Phone Number, Mobile Phone, Multiples Type, Date of Multiples Birth, and a link to contact you by email.
How did you hear about us?: * This Field is required This Field IS visible on profile Information for: How did you hear about us? : Please let us know how you found us. Please let us know if it was a search engine (which one?) or another member (please provide name).
SMOMC Garage Sale News
SMOMC "Multiple Times"
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Type of Multiples: * This Field is required This Field IS visible on profile
Gender of Multiples: * This Field is required This Field IS visible on profile Information for: Gender of Multiples : Please indicate the Gender of your multiples. For multiple sets of multiples, or for quads or more, please select multiple values holding the CTRL key.
Name of Multiples?: This Field IS visible on profile Information for: Name of Multiples? : Please enter the names of your multiples here.
Due Date/Birth Date: This Field IS visible on profile Information for: Due Date/Birth Date : Please enter the Due Date or Birth Date of your multiples
Spouse's Name: This Field IS visible on profile Information for: Spouse's Name : Please enter your Spouse's Name
Wedding Anniversary: This Field IS visible on profile Information for: Wedding Anniversary : Please enter the date of your Wedding Anniversary.
1. Sibling Name: This Field IS visible on profile Information for: 1. Sibling Name : Enter name of any siblings in these boxes.
1. Sibling Birthday: This Field IS visible on profile Information for: 1. Sibling Birthday : Enter the birthday of sibling here
2. Sibling Name: This Field IS visible on profile
2. Sibling Birthday: This Field IS visible on profile
3. Sibling Name: This Field IS visible on profile
3. Sibling Birthday: This Field IS visible on profile
4. Sibling Name: This Field IS visible on profile
4. Sibling Birthday: This Field IS visible on profile
Member Level: * This Field is required This Field IS visible on profile
  Accept Terms and Conditions
Thank you for registering. Please be sure to add admin@smomc.org to your email address book to ensure that you will receive all messages from us. Your registration needs to be approved. You will be notified by email when it has been approved.
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