Online Group Leader and Member Registration Form

Welcome to Moms In Touch International! Will you join the estimated 175,000 moms praying around the world for their children and schools? Please fill out this form so
we can keep you up-to-date on important information and special prayer requests.
Just by signing up, you'll receive our Heart to Heart Newsletter as well as our
monthly e-News.

If you are new to Moms In Touch, once you fill out this form, please visit our Group Locator to get information about leading or participating in a group near you.

Please be assured that your information is kept confidential. It is only used for Moms In Touch purposes, and is not sold or shared with any other organization. Taking just a couple minutes to fill out this form may help even more children and schools be bathed in prayer!

All the fields listed on the form below are required to process your information.
Step #1: Please fill in this form and click on the "next" button below. If more than one school is prayed for in your group, please list additional school names in the comments box at the bottom of the form.

*First Name:
*Last Name:
*Address:
*City:
*State/Province:
*Zip/Postal Code:
Country:
*Phone:
*E-mail:
*Group Status: Group Member Group Leader Other (explain below)
School Name:
School Level: Elementary Middle High School Other (explain below)
School District:
*School County:

How did you hear about Moms In Touch?
  Focus on the Family Women of Faith MOPS Hearts at Home

  A Friend  MITI Event   Other -Please specify:

Comments:  

Moms In Touch International · P.O. Box 1120 · Poway, CA 92074-1120 USA
 1-800-949-MOMS       FAX 858-486-5132