Midwifery Wisdom Collective's Speaker Application for the 2024 Experience

Thank you for your interest in working with us. Please answer each question in its entirety. You have the option to save your application and complete at later time.

*Please note: Applying to Speak with Midwifery Wisdom Collective does not guarantee acceptance.

We will notify you if your application has been approved.

Please email info@midwiferywisdom.com with questions.

Full Name*

First NameLast Name

Address*

Phone Number*

E-Mail Address*

Headshot*

High Resolution JPEG (Max file size 5MB)

CV*

Bio*

*Please note: We will not accept presentations that go over 90 minutes.

1. What is the course / CEU activity title?*

2. Topic Abstract*

3. Who is the course aimed at?*

4. How and why did you choose the subject for the program?*

5. List the names and credentials of each member of the Planning Committee (this may be only you).*

6. Describe how a CPM, LM, CNM or CM participated in planning the session, content development and evaluation of the program.*

7. Describe teaching/delivery method used in the session.*

8. Is pharmacologic content included in the course? If so, what is the duration?*

9. List 3-6 measurable learning objectives.*

10. Course outline including number of minutes per topic.*

11. Please provide 6-8 questions (with answers) on the subject which we can give as a post-test to the participants at the end of the course for issuing the CEUs. We need to send this list of questions (along with the answers) with the application. *

12. Include Bibliography: 6-8 references for sessions up to 4 hours long. At least 60% need to be current (not older than 5 years). Each reference must include a complete citation, including author, date, publisher, etc. Internet sources must also include URL and date accessed.*