CAPPA CHILDBIRTH EDUCATOR TRAINING REGISTRATION

1
Please select the childbirth educator training you wish to addend.* This field is required.
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Name* This field is required.
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3
What would you like to be called at training? What name should appear on your name tag?* This field is required.
4
How should your name appear on your certificate of attendance?* This field is required.
5
Email* This field is required.
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6
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8
How did you hear about this training?* This field is required.
9
Please list any experience or employment in a birth related profession* This field is required.
10
Please list any birth related training and/or certification/credentials* This field is required.
11
Have you attended births other than your own?* This field is required.
Yes
No
12
If so, briefly describe your role and experience.
13
What do you wish to learn at this training?* This field is required.
14
Do you have any allergies of which the group should be aware if we share snacks (answer not required for virtual trainings)?
15
Is there anything else you would like for your trainer to know about you?
16
* This field is required.
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I verify that all of the information given in this application to register for the training is true. I affirm that I am at least 18 years old. I understand that I am not registered until I have received confirmation from debbiehull.doula@gmail.com. * This field is required.
Clear
18
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Childbirth Educator Training - Full Fee
$600.00+Edit
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Childbirth Educator Training - Deposit to hold slotNonrefundable, nontransferable; Fee remainder required by 2 weeks prior to training
$100.00+Edit
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