2021-2022 International Moms Group Registration Form

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Welcome to International Moms Group! We'd love to connect with you this year. Your contact information is confidential. We will only use this information to be in touch with you or to drop off a gift or delivery. We will not share your name, phone number, address, email, etc. with anyone else without your permission.

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First Name: *

Last Name: *

Address (Street, Apartment number, city, state, zip code): *

Phone number: *

Email address: *

What country are you from? *

Affiliations: Please check all that apply. *

OSU undergraduate student

Spouse of OSU undergraduate student

OSU graduate student

Spouse of OSU graduate student

OSU faculty

Spouse of OSU faculty

OSU Visiting Scholar

Spouse of OSU Visiting Scholar

OSU INTO student

Spouse of OSU INTO student

LBCC Student

Spouse of LBCC Student

Community member

IMG Volunteer

อื่นๆ:

จำเป็น

If you (or your spouse) are affiliated with OSU, which department/major do you belong to?

How did you hear about IMG? *

How many children do you have? *

Children’s age group: (Please check ALL age groups that apply.) *

Baby (newborn-11 months)

Toddler (1-2 years)

Preschool (3-4 years)

Early elementary (5-7 years/K-2nd grade)

Late elementary (8-11 years/3rd-5th grade)

Middle school (11-14 years/6th-8th grade)

High school (14-19 years/9th-12th grade)

อื่นๆ:

จำเป็น

If pregnant, when is your due date:

วว

ดด

ปปปป

Would you like to be involved in a small group? *

Yes

Please indicate your preferences for being involved with a small group? Please select ALL that apply.

Virtually

In person (following safety measures: masks, 6 feet distancing, outdoors, etc.) and kid-free

In person (following safety measures: masks, 6 feet distancing, outdoors, etc.) and with kids

Please provide additional information about your preference for the small group meeting time. For example, "I can meet afternoons on Mondays and evenings on Saturday," or "I can make most times work but Thursday's are my preference."

Social Media: Come follow us! International Moms Group is active on WhatsApp, Instagram (follow us at @internationalmomsgroup), and a private Facebook Group (IMG Group Chat). If you would like to be added on WhatsApp and/or FB, please share your Facebook name and/or WhatsApp number below:

Photo disclaimer: By attending this group, you consent to have your photo taken and allow use of these photographs by IMG for promotional purposes. If you have questions, please reach out to Sandy at internationalmomsgroup@gmail.com *

I understand

Have you been vaccinated against COVID? *

Yes

If not, would you like to receive more information and/or get vaccinated?

Yes

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