Application for Funding From The Doula Fund
This form is for Pregnant moms and moms-to-be who need funding from The Doula Fund to have access to doula care.
Email address *
When is your estimated due date? *
What city do you live in? *
Your answer
Is this your first pregnancy? *
Do you already have a Doula in mind? *
If "Yes" to above, what is your doula's contact information?
Your answer
Are you an Ontario Works recipient? *
What is your NET monthly income? *
Your answer
What will your age be on your due date?
Your answer
Do you have any other supports? (Friends, family, a partner, etc...)
Your answer
Is there anything else you feel we should know?
Your answer
Where did you hear of us?
A copy of your responses will be emailed to the address you provided.
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