Contents
OFOM
About Midwifery
About Homebirth
About Safety
Get Involved!
LEGISLATIVE UPDATE!
ACTION ALERT! Ohio Midwives in the News
Newsletters
OFOM Membership
Ideas for Advocacy
Favorite Links
Contact OFOM
Join Us Today!
Ohio Friends of Midwives Membership Form
First Name:
Last Name:
Please enter your credentials or title as you prefer,
comma separated:
(e.g. CD, CPM, CNM, LMT, MD, Doula, etc.)
Credentials:
Business / Org. Name:
E-mail Address:
Website Address:
Work Phone:
Cell/Emerg. Phone:
Mailing Address:
Please be sure to include street address or P.O. Box, City, State and Zip
Please select your level of support below:
Matron ($100)
Supporter ($50)
Organization ($35)
Basic ($20)
Non-supporting ($0)
Other Amount
{Please Specifiy}
In order to learn more about our supporters, we ask that you please take a few minutes to answer the following questionnaire:
Ohio Friends of Midwives Questionnaire
Would you be willing to:
Help with OFOM organization ?
Make telephone calls?
Contact your Congressmen?
Attend hearings in Columbus?
Testify at hearings in Columbus?
Attend OFOM meetings in your area?
Organize OFOM meetings in your area?
Serve as Membership Coordinator?
Manage email requests and referrals?
Manage our Website?
Write our Newsletter?
Edit our Newsletter?
Publish our Newsletter?
Write proposals for financial support?
Other
{Please describe}
The following information may be useful in the future for describing our members as part of generic press releases or to provide data for advocacy..
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Number of Hospital Births
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How many children in your family?
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Your Occupation?
Partner's Occupation?
Please describe your relationship to Midwifery/Homebirth:
Please list any hobbies, skills or interests that you would be willing to volunteer to OFOM:
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©2000-2008 Ohio Friends of Midwives - All Rights Reserved Last updated on: March 12, 2008 Last updated by:
The Webmaster
The information on this page may not be reproduced, republished or mirrored on another webpage or website without the express written consent of Ohio Friends of Midwives.
