Membership Form

Description	Cost	Select
1-year Membership	$45.00
1-year Membership with Brain,Child magazine	$59.00
1-year Membership in two payments of $25 (pay now) and $23 (we will charge your credit card 3 months after your initial payment)	$48.00
1-year Membership with Brain,Child subscription in two payments of $39 (pay now) and $23 (we will charge your credit card 3 months after your initial payment)	$62.00
2-year Membership (save $8)	$82.00
2-year Membership with 2 year of Brain,Child Magazine (save $8)	$109.00

Member First Name

Member Last Name

Chapter Name & Number

Type of membership

How did you hear about Mothers & More?

Current Employment Status

Current and/or Former Job

Please tell me how to start a chapter in my area

Each member of Mothers & More has the right and responsibility to vote in elections for the Board of Directors and any other matters for which our bylaws require a member vote. By returning this form with your dues payment, you are authorizing the Secretary, Mothers & More to cast your vote at the next Annual Meeting of Members or any Special Meetings of Members.

Your proxy will be voted by the Secretary as follows:

FOR the election of all endorsed candidates for the Board of Directors;
FOR the ratification of amendments to the Articles of Incorporation and Bylaws approved by the Board of Directors.

You will receive a postcard via US mail notifying you that the ballot is available at the Members Only section of our website, www.mothersandmore.org, any time a member vote is called for.

You may revoke your proxy:

By submitting a written ballot in any vote called by the Board of Directors; or
Attending in person and casting your vote at the Annual Meeting of Members or any Special Meetings of Members.

This proxy is valid for 12 months from the date this membership is recorded by the main office. If you have questions regarding the proxy voting process, contact info@mothersandmore.org or call the main office at (630) 941-3553.

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