YHWH Family Support Network Opportunity | Social Development

Membership Agreement Form

Please complete this membership agreement to join the Family Support Network Opportunity Association.

MEMBER INFORMATION

Member name

Date of birth

Address (city, street, state, ZIP code)

Phone

Start of membership

Membership program type

FAMILY'S GOALS AND OBJECTIVES

In order to ensure a successful outcome, it is important to know about any current goals, objectives, and future expectations each member of the family is seeking to achieve, so that our services will meet your needs and may require a change in the program. Note any areas that may hinder your success before beginning our Family Support Network Opportunity Association membership.

Goals

Objectives

Target date of achievement

Details

OUR SERVICES

Which services are you most interested in?

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A FAMILY MAKES UP A UNIT OF FATHERS, MOTHERS AND CHILDREN, WHICH IS A UNIT. MEMBERSHIP IS $30.00 PER MONTH FOR ONE FAMILY UNIT, OR $360.00 ANNUALLY. YOU MAY DESIRE TO PAY $180.00 EVERY SIX MONTHS, IT'S YOUR CHOICE. ALL MEMBERS RECEIVE FREE SERVICES AS PART OF YOUR MEMBERSHIP AND DISCOUNTS ON YOUR MONTHLY OR ANNUAL MEMBERSHIP FEES BY REFERRING OTHERS TO JOIN THE FAMILY SUPPORT NETWORK OPPORTUNITY ASSOCIATION. YOU RECEIVE YOUR DISCOUNT AFTER THE MEMBERSHIP FROM YOUR REFERRAL HAS BEEN PAID IN FULL AT THE END OF EACH MONTH.

<span style="color: rgb(0, 0, 0);">I have read and agree to the membership terms above.</span>

Member signature

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Please send a clear photo of your signature.

Signature date