Join CHDPOM

Application Process
1. Fill out the application form below.
2. Your application will be reviewed. Upon approval you will be sent a link to create your password and prompted to log-in and complete payment/registration.
3. Your membership will expire on July 31, 2019 unless you are a lifetime member (no expiry date).
4. If you have any questions/concerns regarding the application form or any general questions about membership, please contact membership@chdpom.com
I would like to apply for:*
- Family Membership- $27 (families with twins who are under 6 years of age)
- Lifetime Membership- Free (families with twins who are 6 years of age or older)
Primary Member Name*
First Last
User Name*
This is the user name you will use to log into the site when your membership application is approved. It cannot be changed later.
Address*
Street Address City State ZIP Code
Email*
Phone*
Secondary Member Name (spouse / partner)
Secondary Member Email
Multiple’s Names
Multiple's Birthdate (or expecting date)*
Name(s) and Birthdate(s) of Other Children (if applicable)
How did you hear about Chapel Hill-Durham Parents of Multiples?
How did you hear about us?
Additional Comments