Life Bearing Doula Association
Membership Form
Name
First Name
Last Name
Email
example@example.com
Address - Note: We will only publish your city or area you serve and state
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (optional - if you want to publish)
Please enter a valid phone number.
What type of doula are you?
Birth Doula
Postpartum doula
Bereavement doula
Fertility doula
Are you any of the below? (Extra services)
Childbirth Educator
Breastfeeding Specialist
Lactation Consultant
Birth Photographer
Other
Do you agree to uphold life bearing principles as a pro-life doula and agree not to support the abortion industry?
Yes
No
I would like more info on this agreement first
You may add a short biography to be included in the listing - email avemariadoula@gmail.com for any pictures you would like to add to your listing
Currently - we are offering free basic listing with possible membership upgrades and such in future - the free listing is for a year. You can also have option to add-in a donation to help us advertise and get information out there... Donations can be done via Square and we will send you link.
I would like to send a donation to help
I cannot donate right now - but I might be able to in 2023
I can donate something in one year after my free listing is up
Not a this time thank you.
Submit
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