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Mothers and More - NE Ohio Chapter 163        

Please Contact Us via email with any questions!
Or, call one of the following people:
Cathy    (440) 285-8162
Becky  (440) 729-2299

Membership Form - Northeast Ohio Chapter #163
One Year Membership (U.S.) $45.00. Make checks payable to Mothers & More.
New Member

For New Members, mail this form along with your check to:
Mothers & More Membership
12130 Falls Road
Chardon, Ohio 44024


For Renewing Members, mail this form along with your check to:
Mothers & More
P.O. Box 31
Elmhurst, IL 60126

Your Name
Your Street Address
Your Street Address (if needed)
Zip Code
Your Phone Number
Your Email
Your Spouse's Name
Your Child(ren)'s name(s) & Birthdays
Former and/or/ Current Occupation
I heard about Mothers & More from:
Check all that apply
Share your story. Help us keep current statistics on sequencing women, their work and family life by filling out the National Office survey and returning it with your Membership Form.
How many children do you have? 1
3 or more
How did you alter your career path in order to be home with your child(ren)? Left full-time job to be home
Left full-time job to work part-time
Left part-time job to be home
Continued in the same position
What reasons entered into your decision to change your career path? Check all that apply I wanted to care for my children myself
I didn't feel I could do justice to my job and parenting at the same time
My former job was inflexible for parenting
I could not afford to work and pay childcare costs
I could not find satisfactory childcare
We relocated
Do you currently work for pay? Do not work for pay
Work part-time at home
Work part-time outside the home
Work full -time at home
Work full-time outside the home
If not currently employed, do you plan to return to work in the future? Probably yes
Probably not
Definitely yes
Definitely not
Don't know
What is your age? 30 or under
41 or over
Highest level of education that you have completed? Technical/vocational degree
High school diploma/ some college
Bachelor's degree/some grad. level work
Master's degree/ PhD/ Professional degree

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