MUMS WITH BUMPS - 2nd Trimester to Birth

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* 1. What is your name?

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* 2. What is your age?

18 to 24

25 to 34

35 to 44

Other (please specify)

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* 3. When is your baby due?

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* 4. Is this your first baby?

Yes

No

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* 5. What days of the week work for you to meet? Currently, Tuesdays or Wednesdays are likely to be the day.

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* 6. Are you ok with 9.15-10.45 meeting time? Mornington location.

Yes

No

Other (please specify)

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* 7. How soon are you able to join the group and start attending?

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* 8. At what email address would you like to be contacted?

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* 9. If comfortable, please share your best mobile number for communication.

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* 10. What suburb are you located in?

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* 11. What is most important to you from such a gathering? Please share things that you would like to get out of it.

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* 12. Please use this space to share any other comments or questions you might have.