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(For new and existing members): Please fill out online or, if preferred, print and send to: Melinda, President

We would like to ensure that we are tailoring our activities, events and “support” around the needs of our members as much as possible. We would greatly appreciate you taking a few minutes to provide us with some feedback. Many thanks!

Name: *
Email: *
Name(s) & Age(s) of children:
1. Reason(s) for joining (or being a part of) MOMS Club (please check all that apply):
  Camaraderie/commiseration with other Stay-at-home-MomsSocialization of/for childrenOther
2. On a scale of 1-10, what level of involvement would you ideally hope to have?
  1 = I have many other friends with kids and just want a little more involvement with the community
10 = I am hopeful I can connect with other moms to see regularly and possibly become lifelong friends
3. Please rate each of the following activities by the following:
  Yes = would love to participate and willing to make changes and sacrifices to existing schedule, etc. to be able to participate
Hopefully = would like to participate and will do what I can to make it without making too many sacrifices
Maybe = it sounds fun only if timing and such work out
No = no interest or ability
  Weekly Playgroups YesHopefullyMaybeNo
  Rotate homes and/or other venues each week to get together with other moms with kids the same age as your own.
  Mom's Night Out/In (in general) YesHopefullyMaybeNo
  The only events with no kids! Everything from crafting nights to movie nights (home and theater) to casual coffee dates and holiday get-togethers
  Crafts Night YesHopefullyMaybeNo
  Out for Coffee or Dessert YesHopefullyMaybeNo
  Movie (at member's house) YesHopefullyMaybeNo
  Movie (theater) YesHopefullyMaybeNo
  Game Night YesHopefullyMaybeNo
  Recipe Exchange YesHopefullyMaybeNo
  Chocolate Studio YesHopefullyMaybeNo
  Preschool Forum YesHopefullyMaybeNo
  Discussion Groups YesHopefullyMaybeNo
  Book Club (parenting books) YesHopefullyMaybeNo
  Book Club (pleasure reads) YesHopefullyMaybeNo
  Other Ideas:
  Breakfast Club YesHopefullyMaybeNo
  Monthly get-together at a restaurant or member’s home to share in coffee, breakfast treats and conversation
  Music & Movement YesHopefullyMaybeNo
  Get together with other members to sing/play instruments/dance, etc.
  General Meetings YesHopefullyMaybeNo
  Monthly meeting to discuss past and future events and share in conversation and play with members of all stages
  Becoming a Board Member YesHopefullyMaybeNo
  All Ages Park Day YesHopefullyMaybeNo
  Beach Day YesHopefullyMaybeNo
  Weekend/Holiday Events YesHopefullyMaybeNo
  Exercise Club YesHopefullyMaybeNo
  Meet with other members to walk or jog or do a “circuit” training or other type of exercise (with kids in tow)
  Discussion Forum YesHopefullyMaybeNo
  Meet with other members to discuss a predetermined topic (i.e. sleeping, teething, tantrums, preschool, etc.) amongst each other; and/or share concerns/questions/issues/milestones
  Babysitting Co-op YesHopefullyMaybeNo
  Other Ideas:  
4. Availability: Please let us know (in general) the best times for planning activities, and times you will definitely not be available.
Please give us a general idea for each day of the week (Sunday-Saturday) from 8am-8pm based on your availability.
As we are all moms, we understand that schedules of babies/toddlers/young children are ever-changing, but the more times you can give us, the better we can be at scheduling activities. Feel free to specify each child's availability separately (for instance if one is in school and another is not).
5. Any other feedback?
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