NC Black Alliance Lactation Cohort Application
Please complete the fields below to join the NC Black Alliance Lactation Cohort. Applicants do not need any prior experience to apply. Through the Lactation Cohort, participants will complete the Certified Lactation Counselor® (CLC) certification and engage in quarterly workshops to deepen their understanding and advocacy skills around Black Maternal Health. The NC Black Alliance Lactation Cohort is a six-month hybrid program. Participants will complete the certification course online, and the quarterly workshops will be in-person. The NC Black Alliance will cover the cost for participants to obtain their certification.
Personal Information
Full Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
*
Please note this opportunity is only available to women in Craven, Beaufort, and surrounding counties in Eastern North Carolina.
E-mail
*
example@example.com
Mobile Number
*
Interests and Experience
The questions below will help us understand how to support and connect you to opportunities after your training.
What's your current job industry/employer?
*
Do you have any personal experience with breastfeeding?
*
How long have you served in or engaged with the community in Craven County, Beaufort County, and/or Eastern North Carolina?
*
What do you hope to gain from this experience?
*
How do you plan to use the skills from participating in the cohort after completing your training?
*
The cohort training requires 4 in-person quarterly workshops hosted by NCBA on Saturdays. Can you commit to participating in 4 workshops?
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Yes
No
Other
Do you require childcare services to attend the quarterly workshops?
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Yes
No
Other
Additional Comments or Questions:
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