MDAH Membership Registration Form



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MEMBERSHIP REGISTRATION

Membership Benefits

MDAH playgroups and field trips
Dads Night Out, MDAH family events
Monthly newsletter, calendar, email group list (Yahoo)
MDAH's network of at home dads

Membership Policy
While the mission, subject matter and activities of MDAH center around the lives and interests of fathers who stay home with their children, any person is welcome to join MDAH regardless of gender, religion, race, sexual preference or any other categorization. Membership is free. However, membership is a privilege and can be denied or revoked for any reason including but not limited to criminal activity or history, abuse of MDAH's privacy policy, or other behavior deemed offensive or destructive to the MDAH community. All MDAH activities are open to members at their own risk.

Privacy Policy
MDAH respects the privacy of its members and will never share or make public any information about a member without the member's expressed consent. With a member's consent, contact and other optional personal information will be made available to directory eligible MDAH members for the sole purpose of networking and building the MDAH community. With a member's consent, they may be included in a restricted access Google Earth map of member locations available to map eligible MDAH members..

Login information to access the MDAH membership directory and login information to access the MDAH Google Earth map is confidential information for the personal use of that eligible member and and may not be further distributed by the member. Copies of the MDAH membership directory or MDAH Google Earth map data downloaded by an eligible member are for the personal use of that eligible member and neither the directory or map nor information contained in the directory or map may be further distributed by the member.

Registration Information
The registration information form is divided into three sections (tables) according to how the information is used. Mandatory entries are indicated with an asterisk * and optional entries are indicated with an italic font. Some elements in the form have hyperlinks to a help document to explain the formatting or desired content for the element and why we ask for that information. Display the full help file by clicking one of those hyperlinks. Registration sets your initial member status to active however you will have to respond to a yearly 'interest inquiry' email (~March) to maintain your active status.


Directory Information Table Any information you enter in the Directory Information Table will appear in the member directory.

*First Name:
Nickname:
*Last Name:
Spouse/Partner Name:
*Street Address:
*City:
*State:
*5 digit Zipcode:
*Email:
Phone number in form nnn-nnn-nnnn *Home: and/or Cell:
Name, gender, birth month and year of children:
Professional Background/Education:
Special Skills:
Hobbies:


Confidential Information Table Any information you enter in the Confidential Information Table will be only be used for planning and statistical purposes. It will be available to the MDAH Planning Committee and designated MDAH Local Area Dads but will not be be published in the MDAH directory or available to the general MDAH membership.

Member Date of Birth (mm/dd/yyyy):
Wedding Date (mm/dd/yyyy):
Comments:
How did you find MDAH?


Options/Confirmation Table Entries in this table designate options for your membership information and MDAH email and confirm your entries.

Include in MDAH membership directory?
Include on Google Earth map?
Add to the MDAH Yahoo email list ?
If you already signed up for the MDAH email list at Yahoo, what email address did you use?
Method to receive MDAH Yahoo email:
I acknowledge that I have read, understand and will abide by the MDAH Membership and Privacy policies and that the information entered on this registration form is truthful. *Type full name here to acknowledge:
Preview your registration
Submit registration & email a copy to self
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