Birth Doula Scholarship
Please take your time filling out the following scholarship application. The application deadline is April 17, 2022 and the recipient will be notified within thirty days of the deadline. Thank you for taking an active interest in the emotional and physical wellness of our communities.
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
What are your preferred pronouns? *
How do you ethnically identify? *
Are you currently a caregiver? *
Have you experienced gestation and the birth of a child? *
Do you acknowledge health disparities stem from poorly maintained and historically neglected relationships within systems of power? *
Can you briefly describe your idea of what a birth doula does? *
What do you feel is something special you offer to the local perinatal health community? *
Would you commit to completing the National Black Doulas Association Birth Doula Training within 365 days of receiving the scholarship? *
If picked do you commit to engaging in one virtual perinatal related event a month (i.e. Baby Cafe meeting or Black Maternal Health Coalition events) *
Is there anything else you would like to share? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy