Individual Membership Application

For Individual Level and Student Level Memberships

Please note:This membership application is for an Individual and Student level memberships.

If you would like to join as an organization and be in the SDCBC Resource Guide, please use the Organization Membership Application.

Membership Level:

Individual $60

Student $25

Please set up my membership to automatically renew

First Name: Last Name: Title: Email: Home Phone: Home Address: City: State: Zip: - Please select your credentials. What best describes your expertise (check all that apply): If other: If you serve breastfeeding families, what region you serve/work in (check all that apply):

Central

North Central

North Coastal

North Inland

East

South

What interests do you have about the SDCBC?

Resource Guide Listing

Breastfeeding in the Workplace/Child Care

Advocacy/Political Action

Membership & Networking

Community Outreach

Professional Educatioin

Fundraising & Grants

Other

If other: What topics would you like to learn about? If other:

Would you like to give a donation? :

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