MIMI

New Chapter Application

All chapters are in PENDING status until reviewed by our Coordintaor Team. After review, you will receive an email communication from your Coordinator.
Log in at at http://momsclub.org/mimi with the email address and password you registered with to check your application status.

Chapter Information

Are you being sistered by another chapter?

If so, which chapter?

If not, how did you hear about us?

State:

Country:

Requested Name:

MOMS Club of

All MOMS Club chapter names should start with "MOMS Club of" and be followed by the city/township/territory that best represents your area.

Requested Boundaries:

Boundaries should define your chapter borders and/or describe your chapter's territory to potential members. Don't worry, if you are unsure what your boundaries should be take your best guess and your Coordinator will help you finalize them.

Email for Members to Contact:

Don't worry if you don't have a separate email. This can be your personal email for now. You can always update it. If your chapter is approved we will provide you with a momsclub.org email address for your chapter to use.

Founder Information

Name:

Contact:

Address:

Password:

Select a password to create your MOMS Information Management Interface (MIMI) account where you can check on your application status, view contact information for your assigned Coordinator and much more.

Payment Information

New Chapter Fee

Online Processing Fee

Total Due

Card Number *

Expiration Date (MMYY) *

CVV *

Cardholder First Name *

Cardholder Last Name *

Cardholder Email *

Cardholder Address *

City *

State *

Zip *

Please note: your payment will not be processed until your chapter is approved.
After it is approved, your payment will be processed and we will send you your MOMS Club Chapter Manual.
There are no refunds after the payment has been processed.

Page will automatically re-direct after application submission with success or error message.
DO NOT refresh page after clicking "Submit Payment" or you may be charged multiple times!

You can pay with confidence! We have partnered with Authorize.Net, a leading payment gateway since 1996, to accept credit cards and electronic check payments safely and securely for our chapters.

The Authorize.Net Payment Gateway manages the complex routing of sensitive customer information through the electronic check and credit card processing networks. See an online payments diagram to see how it works.