Personal tools

Registration Form

Apply to be in a PEPS group!

PEPS will do its very best to place your family in a PEPS Group.  Timing of your placement in a Group can vary between two weeks to four months after your baby is born.  In some instances, registration may not result in placement given these time constraints, but we do our very best to find everyone a Group.  You will be invoiced shortly after your Group begins to meet.

To get the most out of your PEPS experience, please plan to attend regularly.  The more often you go, the better it will be!

(Required)
Your first name
(Required)
Your last name
(Required)
Please select which type of PEPS Group you're interested in.







(Required)
How many will be attending PEPS Group meetings?


If there will be two parents attending meetings (i.e. you answered '2' to the question above), enter the second parent's first name.
If there will be two parents attending meetings (i.e. you answered '2' to the question above), enter the second parent's last name.
Enter your baby's first name (if you know it)
(Required)
Your baby's last name
(Required)
Enter either your baby's date of birth or the expected due date
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Are you already registered with us?
(Required)
If you have one and ever want us to call you on it...
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Your primary email address. Remember that if you will be on maternity leave, your personal email may be the best choice!
An additional email address
(Required)
Your street address
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Your city
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Your county



(Required)
Select your zipcode from the dropdown list
Choose one or more
If you chose "Other" in the previous question, please let us know where you heard about us.
Please use this space for personal comments.
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