@
Trinity
2010-2011
Pre-Registration Form
Name
___________________________________________________________________
Address
_________________________________________________________________
City
______________________________________ Zip
__________________________
Phone
________________________________ Cell
_______________________________
Email:
____________________________________________________________________
Please list all children &
indicate whether if you intend to enroll them in MOPPETS
next year:
___________________________________
DOB: ________________ MOPPETS? Y N
___________________________________
DOB: ________________ MOPPETS? Y N
___________________________________
DOB: ________________ MOPPETS? Y N
___________________________________
DOB: ________________ MOPPETS? Y N
Would you like to receive updates
and information throughout the summer? Yes No
Would you
be interested in helping serve in some capacity next year?
Yes No
_____ Crafts (ideas, preparation)
_____ Publicity (newsletter contributor, photos)
_____ Hospitality (decorating, breakfast, etc.)
_____ Outside Activities
_____ Other
------------------------------------------------------------------------------------------------------------
2010 – 2011 MOPS Year
Regular
Rates:
$23.95
MOPS International
$45
Dues ($5
per mtg x’s 9 mtgs = $45)
$68.95 Total Costs
Pre-Payment
Rates :
$40- Get one meeting free when you pay all dues at first
meeting.
------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------
For
MOPS purposes only: Amount Paid (explain):
_____________________________________________________
Finance: ___________________ Steering:
______________________
MOPPETS: ________________________