APPLICATION
We are happy that you are interested in becoming a member of Highlands Mommies. If you are a parent who resides within our boundaries (I-25 to Harlan and Colfax to Regis - Denver, Colorado), please continue with the application process. If you reside outside our boundaries or are a business, at this time, we cannot accept your application. Membership to Highlands Mommies is only open to families who live within our boundaries as described above. If you have additional questions, please contact the Highlands Mommies moderator: Laverne Hay at: laverne_hay@yahoo.com. Thank you.

 
Member Information
 
(* = Required Information)
* First Name:
* Last Name:
Spouse/Partner First Name:
Spouse/Partner Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip Code:
* Email:
* Home Phone:
   
Mobile Phone:
   
Work Phone:
   
* Password:
* Confirm Password:
 
Parenting Information
 
* Due Date:
      (If pregnant)

Number expecting (if pregnant):

* Child Information (Name,Birthday,Gender):
  1. Name:
  Month & year of birth:
       MaleFemale
  2. Name:
  Month & year of birth:
       MaleFemale
  3. Name:
  Month & year of birth:
       MaleFemale
  4. Name:
  Month & year of birth:
       MaleFemale
  5. Name:
  Month & year of birth:
       MaleFemale
  6. Name:
  Month & year of birth:
       MaleFemale
 
Personal Information
 
HM would love to know a little more about you so that we can plan events/programs that suit your interests. Thanks!
 
* Do you rent?
Yes   No  
If yes, what is your property manager's name and phone number?
How long have you lived at your current address?
Please tell the moderators about yourself and why you would like to join the group.
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