1.What best describes you?

Stay-at-home mom

Work part-time

Work full-time

Student

Other

2.How old is your youngest child?

Pregnant

0–6 months

7–12 months

1–2 years

3–5 years

6+ years

I am not a Mom yet

I am a Mom of Loss

I am a Birth Worker

3.What Time Works Best For Your Schedule?

9:30-10:30 AM

11-12 AM

12:30-1:30 PM

2-3 PM

4-5 PM

5:30 - 6:30 PM

6 - 7:30 PM

6:30 - 8 PM

Other (please specify)

4.What Days Work Best For You?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

5.What Current Groups Are You Interested In?

The Ladies Lounge - Coffee & Donuts with Moms

Blooming Mothers - Postpartum (New Mom) Support Group

Baby & Me: Music Class

Wonder & Whimsy: Preschool Story Time

Mother Nurture: Motherhood Support Group

Growing Together: Pregnancy Support Group

Seeds of Hope: Fertility Support Group

Healing Hearts: Miscarriage Support Group

Nurturers' Lounge: Birth Workers Support Group

Soothe & Renew: Self Care Group

6.What other groups would you like to see at Community Motherhood?

7.What would make you feel more supported in motherhood?

8.Are there any barriers keeping you from attending groups?

9.Would you be interested in monthly membership options, to save money and to plan your month in advance?

Yes

No

10.Would you like to be notified when new groups open? If Yes, Please enter your email address below: