MIMI

Name:

Contact:

Address:

Birthday:

Home Chapter:

Chapter State:

How long have you been a MOMS Club Member?

What jobs/offices have you held with the chapter? What programs/activities have you started or led?

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How has the MOMS Club helped you?

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Did you experience any problems during your time in the MOMS Club? If so, how were those problems resolved or what did you learn from them?

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Why do you want to be an International MOMS Club Volunteer?

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Do you volunteer for anyone else? Please list all your volunteer positions and when you did them?

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Do you have any special skills/talents/Hobbies (ie: other languages, proficient in any computer programs)?

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What have you enjoyed most in previous volunteer experiences? Least?

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Referred by (if applicable):

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