Birth Justice Warriors Application
Thank you for your interest in becoming a Birth Justice Warrior.
We look forward to reviewing your application.

The application will be open until midnight October 12.
Successful applicants will be notified of their acceptance into the training workshop by October 15.
The Birth Justice Warriors Training Workshop will be held from 10 am to 2 pm on October 24 at
Nassau NFP - Visiting Nurse Service of New York, 375 N Broadway, Suite 101 Jericho, NY 11753.
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Email *
Full Name *
Phone Number *
How do you identify your race/ethnicity? *
Occupation *
How many years of experience do you have in this field? *
What experience do you have with peer health education? *
What experience do you have with pre-natal care and/or pre-natal health education? *
Why would you be interested in being a Birth Justice Warrior in your community? *
How would you describe your comfort level with public speaking? *
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