Join Here

Your Name (required)

Your Email (required)

Subject

As a church, ministry, organization or individual that is beginning a M.O.M. Initiative group in your area, The M.O.M. Initiative looks forward to connecting mentor groups with moms who are in search of mentor groups in their area.

We also ask you to check that you agree with our Statement of Belief which follows the basic beliefs of the National Association of Evangelicals.

 Yes No

Please fill out the information below and check the appropriate box in order to let us know what you would like to be made public (listed on our website) and what you would like to remain private. (You may wish to have city & state listed only.)

PLEASE NOTE: We will NOT share any information except that which you request. If you choose, yes, we will publish your information, so that others may connect with you.

NAME OF CHURCH / ORGANIZATION / MENTOR:   MAKE PUBLIC? (Choose Yes or No for each one)

NAME OF CHURCH / ORGANIZATION / MENTOR:

 Yes No

ADDRESS OF CHURCH / ORGANIZATION / MENTOR:

 Yes No

PHONE NUMBER OF CHURCH / ORGANIZATION / MENTOR:

 Yes No

CONTACT NAME:

 Yes No

WEBSITE:

 Yes No

Email Information:

 Yes No

OTHER INFORMATION OR COMMENTS: