Use Last Year's Information

 

Family Information

Parent name(s):
Street:
City, State, Zip:
Home Phone:
Cell Phone:
Email address 1:
Email address 2:
DTC/LID:
(if waiting)

 

First Child Information

Name:
Birthday:
School Name:
Grade in School:
SWI:
Adoption Day:
Province:

 

Second Child Information

Name:
Birthday:
School Name:
Grade in School:
SWI:
Adoption Day:
Province:

 

Third Child Information

Name:
Birthday:
School Name:
Grade in School:
SWI:
Adoption Day:
Province:

 

 

Other children:

(please note DOB and grade-in-school)

 
 
Please fill out the following form and then click the SUBMIT button at the bottom.

If this is a renewal, and your information has not changed in the past year, then only fill in the following four items:
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From time to time the Families of The China Moon may use photographs of FCM members, taken at FCM public events, in FCM publications including promotional brochures.  All such photographs would be used without disclosing the names of the included individuals.  By clicking SUBMIT above you agree to FCM's use of such photographs.