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* 1. First and Last Name

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* 2. Expected Due Date

Date

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* 3. Phone Number

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* 4. Email Address (Optional)

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* 5. Where do you receive prenatal care?

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* 6. Which pump would you want to receive?

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* 7. Are you in need of a car seat?

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* 8. Which class will you be attending?

English classes will be held at the Martin Memorial Library in Williamston NC (200 N. Smithwick St. Williamston 27892), or at the Plymouth Church Of Christ in Plymouth NC (905 Washington St. Plymouth 27962). Refreshments will be provided at each class.

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* 9. Once you fill this out you are registered for the RIMC Class.

Please feel free to offer any more information to us in the comment box below.

We do have limited car seats, if you are in need of one then please let us know. Receiving a car seat will require going through an additional educational session provided by a CPST.

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