WHMS Membership Application, 2018 Program Year
Please visit http://www.welcomehomesac.org/membership to view full details regarding the types, benefits, and fees for each membership.
Your Full Name
Your Phone Number
Your Mailing Address
Your E-Mail Address
Your practice information (for Professional Memberships only)
Your logo/photograph (for Professional Memberships only)
County of Residence
License Type and/or Credentials (for Professional Memberships only)
Midwifery School Where You Are Enrolled (for Student Midwife Memberships only)
Membership Tier (Includes Fee per Year)
Are you available to volunteer at outreach events for WHMS on a quarterly basis?
Are you available to attend Advisory Board meetings for WHMS on a quarterly basis?
Would you like to be added to the private Facebook group for WHMS members? If so, include your Facebook e-mail address here:
How would you see your role as a member of WHMS?
What do you feel your membership would contribute to WHMS?
Information about Membership
Following the receipt of your completed application, you will be issued an invoice for your membership fee.
This fee is due on receipt of the invoice, and your membership will renew each year on receipt of the invoice.
Following the payment of your member fee, you will be issued a new member packet and added to the e-mail list for WHMS Members.
To update your contact information at any time, e-mail hello@welcomehomems.org.

Thank you for supporting access to midwifery care and training in our region!

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