New Member Application

First Name: Last Name: Email: Phone: Home Mobile Other Work Address: Address Line 2 City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip Code: - Zip Suffix Area of Seattle: (reference map below) Neighborhood:
Used in the member directory to connect families within the same neighborhood (e.g. Ravenna, West Seattle, Shoreline) Partner/Spouse First and Last Name, if applicable (important for access to events)
For multi-parent/poly families, enter names separated by a comma. Partner/Spouse Email
For multi-parent/poly families, enter email addresses separated by a comma. First and Last Name and Role/Title of additional adult(s) in your household who regularly provide childcare and might attend events with your children. For example, "Jane Smith (grandparent), John Doe (au pair)".
Names can be edited in the future, if childcare providers change. Highest Order of Multiples Twins Triplets Quads or more Type of Multiples Fraternal Identical Complicated Unknown Birth year of multiples. Enter as 4-digit year (xxxx). Information allows members to search in the directory for families with similar-aged children. 40 Week Due Date (which may be different than your multiples' birthdate).
If you are currently expecting or have multiples younger than 6 months old, 40-week date is referenced if you choose to sign up for a PEMS Group. Name or Initial Birthdate/Due Date Gender (optional) Name or Initial Birthdate/Due Date Gender (optional) Name or Initial Birthdate/Due Date Gender (optional) Name or Initial Birthdate/Due Date Gender (optional) Name or Initial Birthdate/Due Date Gender (optional) Name or Initial Birthdate/Due Date Gender (optional) Member-Selected Subgroups Member Willing to Help With Help us learn more about you and your family. What unique or interesting talents, skills, or knowledge might you bring to our organization? Any other comments? If you are a new member, how did you hear about SFOM? Check all that apply. If you chose "other" under referral source, how did you hear about us? Captcha