1. MommyParties sponsored by MOMS’ NIGHT OUT Application

If you are interested in receiving a MommyParties sponsored by MOMS’ NIGHT OUT Kit and hosting an event, please register here. Limited quantities are available.

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* 1. Please enter your contact information below (No P.O. Boxes):

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* 2. What age group do you fall into?

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* 3. What are the gender(s) and age(s) of your children in the home? Please select all that apply.

  Under 2 2-4 5-7 8-10 11-13 14-17 18+
Boy
Girl

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* 4. Which of the following social networks do you interact with regularly? Please select all that apply.

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* 5. Blog Name/URL

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* 6. Approximately how many monthly readers does your blog have?

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* 7. Twitter ID (if applicable)

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* 8. How many Twitter followers do you have?

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* 9. Facebook Fan Page URL (if applicable)

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* 10. How many Facebook friends/fans do you have?

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* 11. Do you belong to any groups or organizations? (i.e. networking groups, PTA, professional groups, sports leagues, book clubs, social groups, etc)

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* 12. If so, how many groups would you say you belong to?

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* 13. Do you have a Papa Murphy's location within driving distance of your home?

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* 14. Do you typically look for natural alternatives to sugar for your family to use?

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* 15. How familiar would you say you are with the brand In the Raw?

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* 16. Have you ever hosted a MommyParty before?

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* 17. We are looking for parties to be held between May 1-9, 2014. What is the potential date for your event?

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* 18. By taking part in this program, do you agree to host a party during the designated time frame and share details of the event on your blog and social media channels?

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