Virtuous Doula Training Registration

Virtuous Doula Interest Form

Thank you for your interest in becoming a Certified Virtuous Doula (CVD) with Virtuous Doula Training Academy and your interest in the Asase Ye Duru Doula Training Scholarship! We take what we do very seriously and want to ensure that you are prepared and ready to serve your community in a radical way. Please let us know more about you by filling out the information below.
Potential Student's Name*

First NameMiddle InitialLast Name
Are you an Illinois Or Missouri Resident*

IllinoisMissouri
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
In what capacity are you coming to us?

To Become A DoulaI'm Already A Doula But Would Like to Renew With VDTAI Was Enrolled As A Virtuous Doula and Would Like to Complete My Course Work
Which cohort are you wanting to attend?*

Cohort 8: Dec 17, 2024-March 6, 2025Cohort 1 (IL): Dec 16, 2024-March 5, 2025Cohort 1 (Spanish): Dec 17, 2024-March 6, 2025Cohort 9: Jun 10, 2025-Aug 28, 2025Cohort 2 (IL): Jun 9, 2025-Aug 27, 2025Cohort 2 (Spanish): Jun 10, 2025- Aug 27, 2025I'm trying to recertify with VDTA
I understand that spots in each cohort are limited and I am ok with being moved to another cohort.*

YesNoPossibly, with more information.Other
What is your highest level of education?*
What do you currently do for a living?*
Why do you want to transition to birthwork?*
Do you have any experience with birth/birthwork?*

YesNo
If yes to the above question, describe your experience below.*
Do you have any experience with community work/advocacy?*

YesNo
If yes to the above question, describe your experience below.*
In 500 words or less, please tell us why you're choosing Virtuously B'Earthed Doula Services to complete doula training with.*
Please attach a headshot with your application.*

Cancelof
Should be Empty:

Virtuous Doula Interest Form