Name:_________________________________________

Address:______________________________________

City:__________________________________________

State:________________Zip:______________________

EMAIL Address:________________________________

Phone:___________________Cell:_______________

How did you hear about us?______________________________________________

______________________________________________

Type of Membership Desired: 

Full Membership $75.00 [   ]         Affliate $25.00  [   ]

Amount Enclosed: _________

Send this membership application and appropriate fees to:

Valley Foothill Doula Collective
ATTN: Cyndi Whitwell
2610 27th Street
Sacramento, CA  95818

Or Call (888)DOULA-4-U

 http://doulacollective.bizland.com