Aspiring Student Midwife Preparation Course
This form must be completed along with £50 deposit to secure your place on your chosen workshop date.
Email address *
Name *
Address *
Mobile Number *
What are you currently doing towards your midwifery studies? IE access, GCSE etc *
University intending to apply too? Including start year? *
Workshop Month you want to book *
Required
Are you interested in the Breastfeeding Peer Supporter Certification *
Do you have any health issues or disability? *
Do you have online access? The workshop days are online via skype. I will contact you about this. *
What other roles or background do you have? Please include paid and voluntary experience. *
What are you hoping to gain from this preparation course? *
COST: £175 (deposit of £50 will secure your place)Handouts will be available on the day electronically. All other resources via the members only log in once full payment is received. *
Cancellation of bookings; Please see information on this on the main practitioner page. If for any reason the study day is cancelled you will be offered a full refund will be given or you can be transferred onto the next course. Once payment and booking form has been received you will receive confirmation of your booking. (deposit refund is only available 14 days after booking) Please note: Places are limited per workshop. *
Payments must be made along with this form submission, bookings will not be accepted if payment is not made. You will receive further information on how to make payment once this has been received. *
Do you give consent to join a delegate WhatsApp group? *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of EBM. Report Abuse