MMA Membership Form

Are you joining or renewing as a:*

Membership Options

Midwife Membership

A Midwife is any person that qualifies as a trained Midwife.

$75.00

Student

A student midwife is a person who is currently enrolled in a midwifery school or program, or who is currently serving in an apprenticeship or internship.

$50.00

Retired Midwife Membership

A Retired Midwife is a person that formally practiced midwifery but is no longer taking clients and considers her/himself retired.

$50.00

MMA Supporters Membership

Without consumers like you, midwives wouldn't exist in Missouri. Your part in helping midwives stay legal and hired is undeniable. An MMA supporter can be a homebirth mom, midwife advocate, medical professional, or anyone who wants to be a part of championing midwives. This money goes directly to help support continued access to midwives in Missouri. *MMA Supporters do not have voting privileges.

$30.00

Name*

First NameLast Name

Preferred Pronouns

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Midwifery Practice Name:

Would you like your midwifery contact information listed in the directory on our website for potential clients?*

Do you consent to your contact information being shared amongst members?*

Please indicate your midwifery credential:*

CPMCNMBoth CNM & CPMOther

If you are comfortable, please include and logo or image of yourself to represent your practice!

Browse Files

By signing my name below I agree to follow the Missouri Midwives Association Code of Ethics.

Date

Payment Methods

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