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Yes, I would like to become a member of the Groupe MAMAN and
so help contribute to the recognition and promotion of the autonomy
of childbearing women. I will also receive the MAMANzine (Groupe
MAMAN's newsletter).

Note : All we do is voluntarily done,
so we cannot guarantee a regular publication of the MAMANzine.

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As well, I would like to give some
time to the activities of the Groupe MAMAN (newsletter, meetings, internet
site, testimonies, fundraising, mailings...).
| Name: |
| Address: |
| Postal code: |
Telephone: |
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E-mail:
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| I enclose my contribution
($15.00 minimum): $ |
Note
: Your support is important for us. If the membership fees compromise
your adhesion, contribute according to your possibilities.
(Please print and return form with payment to Groupe MAMAN)
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