The Educated Birth Gift Application for Individuals
Enter to be selected for: a $50 credit in The Educated Birth Shop, AND a social media boost via The Educated Birth blog, Instagram and Facebook page.

This application is fit for existing birth workers seeking continued studies and/or professional development and are actively seeking financial assistance. As such, applicants should be able to demonstrate a long-standing commitment to this work, and would ideally be able to offer a link to an existing fundraising page.

First Name *
Last Name *
Email Address *
Instagram Handle *
Website *
Phone Number *
Street Address *
City *
State *
Zip Code *
Country *
Bio Photo(s) *
Submit 2-3 photos that may be used in social media and on the blog to show who you are.
Working Photo(s)
If available, submit 2-3 photos of you doing the work that you do that may be used in social media and on the blog.
Bio + Interview Questions
If selected, these are the questions and answers that may be shared on The Educated Birth blog.
Describe yourself. What are the most readily identified aspects of your personality, and what truths about yourself may surprise someone? *
How do you pursue reproductive justice in your life and your work? *
Who has shaped you and/or what drives you to do the work you do? *
What are some things you do to take care of yourself as you pursue the work you do? *
What does a day in your life look like? *
What areas of expertise do you have that folks should know about? *
Where do you see yourself and your work in a year, 5 years, 10 years? *
Do you have a donation page we can link to? *
Anything else you’d like to say? *
Gift Application Only Questions
The answers to these questions will not be shared publicly.
Are you raising money publicly already? *
Specifically, how would monetary gifts be used to pursue reproductive justice through your work? *
Never submit passwords through Google Forms.
This form was created inside of Cheyenne Varner, LLC. - Terms of Service