Course Registration Form

ICEA Certification workshop Registration

Fill out the form carefully for registration
Name

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Desired workshop
Month of desired workshop begins (see schedule workshops or contact me)
Something about yourself (career, hobbies, past experience in this field, etc) *

List any additional comments, concerns or anxieties about becoming a birth professional and/or this workshop.

How did you hear about this workshop? *

Word of mouth ICEA website Global Birth Education Consulting website Pinterest Facebook Other

I wish to share my contact information with my fellow classmates for collaboration and educational purposes only. *

Yes No
Form of payment *
To confirm your enrollment, please finalize the discounted Zoom Live course payment of $500. A further discount will be provided if you are taking both courses at the same time. The discounted price for two (2) courses is $900. I will send out class materials as soon as your enrollment has been confirmed.

Venmo: @Tamela-Hatcher (8479)

CashAPP: $TamelaHatcher

Check/Cashiers Check: Tamela Hatcher PO Box 62 New Virginia, IA. 50210

I am passionate about teaching and birth, if you have any question, please reach out to me. My contact information is listed below. I look forward to working together to improve birth outcomes.

icea.tamelahatcher@gmail.com

2016-2019 Director of Education

International Childbirth Education Association (ICEA)

515-971-8479 (phone/text)

www.facebook.com/globalbirthed/

www.pinterest.com/hatcher0327/

www.linkedin.com/in/tamelahatcher/

WeChat ID: TamelaHatcher

Global Birth Education Consulting (GBEC)

https://gbec-merchandise.weeblysite.com/
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ICEA Certification workshop Registration