Professional Membership Scholarship APPLICATION - Birth Professionals with a Disability

Professional Membership Scholarship - Birth Professionals with a Disability
We are thrilled about your interest in an Evidence Based Birth® Professional Membership scholarship! This scholarship is for birth professionals who identify as a person with a disability.

We do not define “disability,” however, most people who apply for this scholarship identify as having a physical, mental, cognitive, or developmental condition that impairs, interferes with, or limits a person's ability to engage in certain tasks or actions and more!

With this scholarship, you can receive a partial scholarship of $14.99/month membership fee.

We highly encourage you to use your own voice and not use artificial intelligence (AI) tools to complete your application. If you need these tools to organize your thoughts, that is fine. But we ask that you please still use your own words when answering the questions and sharing with us why you are applying. If we believe AI has been used, we will scan it throught a checker and unfortunatly have to decline those applications. We want to hear from you and not machine-generated responses!

Please make sure you are signed up to receive email communications from EBB. If you unsubscribe or have unsubscibed from our email list, you will not receive a notification about your application status.

Applications are accepted on a rolling basis. You should hear about your application status in about two weeks time.

** Please collect all information and fill out the application in its entirety. You will not be able to save and resume once started.

We look forward to reviewing your application!

Thank you.
Applicant Information
Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Professional Information
DoulaChild Birth EducatorMidwifeNurseDoctorOther
Tell us about yourself!

Please provide at least one paragraph for each of the questions below. Thank you!
Please describe your disability here.*
Please describe the population in which you serve, and how you will use the Professional membership to help your community. (150 word minimum)*

0/0
Please explain your reason for requesting a scholarship. (150 word minimum)*

0/0
Please describe your financial situation. Will you be able to provide proof of income if asked? (If proof of income is requested, Evidence Based Birth will hold the information as strictly confidential and the information will be shared among the EBB administrative team only. Financial need will be assessed and determined using several criteria at the discretion of EBB.)
Agreement
I certify that the information I have given on the application is complete and correct. I understand my failure to provide complete, accurate and truthful information on the application will be grounds to deny or withdraw my application.
YesNo
Signature*
Full Name*

First NameLast Name
Date Signed

MonthDayYear
Should be Empty:

Professional Membership Scholarship - Birth Professionals with a Disability

Applicant Information

Professional Information

Tell us about yourself!

Agreement