Course Registration Form

ICEA Certification workshop Registration

Fill out the form carefully for registration
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
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.

I wish to share my contact information with my fellow classmates for collaboration and educational purposes only.
Form of payment
To confirm your enrollment, please finalize the discounted Zoom Live course payment of $525. A further discount (10%) will be provided if you are taking both courses at the same time. You can pay by credit card at https://www.globalbirthed.com. I will send out class materials as soon as your enrollment has been confirmed.

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://www.globalbirthed.com
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ICEA Certification workshop Registration