APPLICATION
Please complete the form for review by our group administrators.
Member Information
(* = Required Information)
* First Name:
* Last Name:
Spouse/Partner First Name:
Spouse/Partner Last Name:
Address 1:
Address 2:
City:
State:
--- Select One --
Armed Forces Americas
Armed Forces Europe
Alaska
Alabama
Armed Forces Pacific
Arkansas
American Samo
Arizona
California
Colorado
Connecticut
Canal Zone
District of Columbia
Delaware
Florida
Federated States of Micronesia
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Marshall Islands
Michigan
Minnesota
Missouri
Northern Mariana Islands
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
CW of Northern Mariana Islands
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Palau
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Zip Code:
* Email:
Home Phone:
 
Mobile Phone:
Work Phone:
* Password:
* Confirm Password:
Parenting Information
Child Information (Name,Birthday,Gender):
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1
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6
1. Name:
Month & year of birth:
Month
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Year
2010
2009
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1967
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1963
1962
1961
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1959
1958
prior to 58
Male
Female
2. Name:
Month & year of birth:
Month
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5
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7
8
9
10
11
12
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
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2000
1999
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1991
1990
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1982
1981
1980
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1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
prior to 58
prior to 58
Male
Female
3. Name:
Month & year of birth:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
prior to 58
prior to 58
Male
Female
4. Name:
Month & year of birth:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
prior to 58
prior to 58
Male
Female
5. Name:
Month & year of birth:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
prior to 58
prior to 58
Male
Female
6. Name:
Month & year of birth:
Month
1
2
3
4
5
6
7
8
9
10
11
12
12
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
prior to 58
prior to 58
Male
Female
Personal Information
 
mvm would love to know a little more about you so that we can plan events/programs that suit your interests. Thanks!
* What is your relationship with MVM or to the child(ren) listed?
Mother
Father
Staff or Faculty
Other
If other, please specify
Member Occupation
Please let us know if you have an interest or expertise in helping in any of the following areas. Checking the boxes does not bind you to volunteering. We may contact you in future or invite you to become a member of one of our volunteer committees.
Art and creative projects
Baking
Cooking
Field trips
Foreign language
Furniture repair
Materials making
Outdoor garden projects
Sewing
Special projects
Telephone calls
Other
If other, please indicate
Processing...
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