Fathers and Families: Membership Form

If you are interested in becoming a member of Fathers & Families, please scroll down to our membership form. If you are an existing Fathers & Families Member, and would like to contribute please click on the button below:

For all the benefits of membership, click on "Member Benefits" on the navigation bar above.

Fathers & Families' activities are funded primarily by our individual contributors. Although we seek foundation and government support, we believe that individual donors like you -- fathers, second wives, grandparents, siblings, and concerned citizens -- will remain the backbone of our financial support in 2005 and 2006.

We have a number of levels of membership and would encourage you to give at the highest level possible:

Suggested Contribution Levels

Patron:	$5,000 or more
Benefactor:	$2,500 to $4,999
Visionary:	$1,000 to $2,499
Gold Member:	$500 to $999
Silver Member (minimum for attorney referral service):	$100 to $499
Member:	$50 to $99

If you are not currently a Member, please fill in all required fields and click "Continue."

Bold red text denotes a required field

Member Information

Title

First name

Middle Name

Last name

Suffix

Email

Occupation

Address

Home Business

Company name
(if Business address)

Street

City

State/Prov

required for USA/Canada

Postal code

required for USA/Canada

Country

Phone

Home Business

Phone number
(Include area code)

Phone extension

Fax

Home Business

Fax number
(Include area code)

Issues of concern

DOR/Child support	Restraining Orders
Custody/Access	Moveaway
False Abuse Charges

Are you a grandparent?

Yes

Are you a second wife?

Yes