Apply – The Midwifery Institute

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Midwifery Program Application

The Midwifery Institute’s Midwifery education program is a comprehensive and rigorous education program in the field of direct-entry midwifery.

1/18 NOTE: Cohort A is filling up! Apply now to reserve your spot as cohorts are determined on a first come, first serve basis.

PLEASE NOTE: At the bottom of this page is a link to pay the application fee of $25. Applications submitted without payment will not be processed.

Preferred Name

Prefix

Legal First Name *

Legal Last Name *

Date of Birth *

Phone *

Email Address *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Pronouns *

If Other, Please Provide

Have you earned a High School Diploma or GED? *YesNo

High School Diploma, Transcript or equivalent

No file chosen

Have you completed a Doula certification Course? *YesNo

Doula Certificate

No file chosen

Preferred Session Start Date *

Fall 2023Winter 2024Summer 2024

Preferred Student Status *

Cohort A- 3 Sessions per year, Year RoundCohort B- 2 Sessions per year, Sept-MayCohort C- 1 Session per year Sept-May

Why do you want to become a Midwife? (100 words minimum) *

How do you intend to serve your community as a midwife? (100 words minimum) *

Will you be applying for our scholarship Program? *YesNo

Consent *

I understand that the information provided will be used to determine my fitness for the Midwifery Institute's Midwifery program. I understand that failure to provide key information may result in my application being rejected.

Consent *

I understand that failure to pay the $25 application fee at the link below within 24 hours of application, will result in my application being dismissed, and I will not be considered for the program at all.

Pay The Application Fee

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