Birth Matters Virginia | Business Membership Renewal

Business Membership Registration Renewal Form Has the following information changed? no, click here

Business Name:
Contact Person:
Street Address:
City:
State:
Zipcode:
Phone Number (with area code):
Business Web Address :
Which BMV local chapter do you wish to be "attached" to:
Preferred email address for the Yahoo! group invitation:
Preferred email address for correspondences
Description of your services as it ties into the Birth Matters VA mission *75 word maximum

After you have submitted this registration form you will be directed to payment information. Credit card payments are secure using PayPal. You do not need to register for a PayPal account.

Your registration may take two to three weeks to complete. You will receive a new member packet in the mail and an invitation to the Birth Matters Virginia Yahoo! Group for members by email. Please look for the invitation because it will expire two weeks after it was sent. If you do not receive your email invitation within three weeks please contact: Kathy Hubbard at tidewater@birthmattersva.org. We appreciate your patience and thank you for supporting evidence based care in Virginia.

Birth Matters Virginia is a 501(c)3 non-profit organization. We have no religious or political affiliation.
All donations are tax-deductible. Click here to make a donation.

Birth Matters
PO Box 3540, Lynchburg, VA 24503
mfschuppe@verizon.net