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Member Interest Form

We have created a survey to help better network our members and hear some feedback about what members would like to see more of in ADCAN. We love if you could take a moment to fill it out. We hope to add these facts to the membership directory so members can know a little more about one another.

 

* Required fields
Name *
E-mail Address *
How long have you been a nanny? *
Address
Phone Number
Live In or Live Out?
Gender/Ages of the children you care for
Birth date
Birthplace
Are you are interested in being contacted about playgroups in your area?
Area
How did you learn about ADCAN?
Hobbies and Interest. Please check below and add here if there are others not listed that you would like to share.
Horseback Riding
Outlet Shopping
Sporting events
Rummage Sales
Entertaining
Comedy Clubs
Movies
Rollerblading
Hiking
Bike Riding
Bowling
Cooking
Dining-Out
Museums
Volunteering
Traveling
Dancing
Kayaking
Sailing
Exercise
Concerts
Tennis
Skiing
Golf
Swimming
Camping
Crafts
What would you like to get out of this group?
What topics would you like to learn/hear more about from speakers?
What charity or public service events would you like to see us be involved in?
Any additional comments?

I have read and agree to the Privacy Policy *

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Thank you very much for your time!