MOPS Registration Page Mops Dues are $90 for the year, which can be paid at the first meeting. Please contact the coordinators for more information, or questions. MOPS Registration Form Welcome! Please complete this form so we can learn about you! Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Phone Number*Email* Birthday* MM DD YYYY Have you attended a MOPS group before?*YesNoIf yes, where?*Home church (if applicable)How did you hear about this MOPS group?Please list your child(ren)'s name(s) and birthdates(s):*Click the + button to add lines for more names.NameDate of Birth Husband's Name (if applicable)Mentor MomI would like to be assigned a Mentor MomYesNoRequest Mentor MomI would like to keep the same Mentor MomYesNoCommentsThis field is for validation purposes and should be left unchanged.