Scholarship Form
PALS Doulas offers a scholarship for birth doula training workshops accepted by our organization for the purpose of certification, membership, as well as PALS sponsored workshops, certification and processing fees. Scholarship awards are based on the following:
- Identifying with an underrepresented community
- Financial need
- Current or planned work with underserved communities (communities with high infant and maternal mortality rates, communities facing health disparities, low income, minority, LGBTQIA+)
- Residence in Washington State
- Involvement in the WA birth community
- Alignment with PALS Mission, Vision, and Goals
- Availability
* Required
Have you read the PALS Mission, Value, and Goals statements?
*
Yes
No
Required
Today's Date
*
MM
/
DD
/
YYYY
Your name:
*
Your answer
Your address (street/city/state/zip):
*
Your answer
Your email address:
*
Your answer
Your phone #:
*
Your answer
I am applying for
*
Training/membership/certification scholarship
Membership and Certification
Other workshop sponsored by PALS
2019 Northwest Doula Conference
Are you currently a certified doula?
*
Yes
No
If yes, what organization are you certified with?
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
