Certification Programme Registration Form

Certification Enrolment

Please fill out the form and pay the enrolment fee
Name*

First NameLast Name
E-mail*
example@example.com
Mobile number*
Address

Street Address

Street Address Line 2

CityCounty

Postcode
Date and venue of course attended: *
Birth doulaPostnatal doulaBirth & Postnatal doula
YesNoOther
Previous/current career:*
I want to work as a doula because...*
The strengths I believe I bring to the role are...*
The areas I feel I need to work on are...*
What are you looking for from your Doula Coach?*
After attending the training course are there any burning questions you have?*
I understand this information will be shared with my coach.
TERMS & CONDITIONS: The Certification Programme includes a 24 month period of coaching support with your chosen Doula Coach. Your 24 months begin from the date you sign up with your coach. If you need more time beyond the 24 months you will be able to re apply, and any client work already signed off will be carried forward. There may be times in life when you need to pause your Certification Programme. You can put the process on hold if you are dealing with a bereavement, long term health challenges, or maternity leave. The intention is always that you continue when you feel ready, and we will support you in easing back in when the time is right.*

I have read and understood the Terms & Conditions and by ticking this box I agree to them.
My Products
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Enrolment Fee - Birth & Postnatal
Birth & Postnatal doula certification

£40.00



Enrolment Fee - Birth only
Birth doula certification only

£40.00



Enrolment Fee - Postnatal only
Postnatal doula certification only

£40.00



Total

£0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Certification Enrolment