Virtuous Doula Training Academy Training Application
Welcome to the Virtuous Doula Training Academy (VDTA) Program & Competitive Scholarship Application. VDTA is committed to expanding equitable, culturally responsive, community-centered birthwork and perinatal health support across Missouri and Illinois. Due to limited funding availability, scholarships are awarded through a competitive review process based on: demonstrated financial need community impact alignment with VDTA’s mission commitment to completion leadership potential and overall application strength. Please complete this application thoughtfully and honestly. Incomplete applications may not be considered. Applicants selected for scholarships will be notified prior to the start of the next training cohort.
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Getting to Know You
Please provide your basic contact and identification information so we can communicate with you throughout the application and training process.
Full Name
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First Name
Last Name
Pronouns (Optional)
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email Address
*
example@example.com
Emergency Contact Name
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Community and Background Information
We recognize that identity is personal and layered. These questions help us understand who we are reaching and where gaps in access may exist. Please answer in the way that feels most comfortable to you.
Age Range
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18-24
25-34
35-44
45-54
55-64
65+
Gender Identity
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Woman
Man
Non-Binary
Gender-Expansive
Prefer not to answer
Other
Race/Ethnicity
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Black or African American
White
Hispanic or Latino
Asian
Native American or Alaska Native
Native Hawaiian or Pacific Islander
Middle Eastern or North African
Multiracial
Prefer not to answer
Other
Highest Education Level
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Less than high school
High school diploma or GED
Associate’s degree
Bachelor’s degree
Graduate or professional degree
Prefer not to answer
Other
Household Income Range
*
Under $25,000
$25,000–$49,999
$50,000–$74,999
$75,000–$99,999
$100,000–$149,999
$150,000+
Prefer not to answer
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Reflecting on Your Readiness for Birthwork
Birthwork requires compassion, emotional awareness, accountability, communication skills, and a willingness to grow. This self-assessment is not about perfection—it is an opportunity to reflect honestly on your current strengths and areas for development as a future doula or perinatal health worker.
I work well with people from diverse backgrounds.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I am comfortable discussing trauma, grief, racism, or loss.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I understand maternal health disparities affecting my community.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I can work respectfully with instructors and peers of different ages.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I can receive constructive feedback without shutting down or becoming defensive.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I am open to learning even when information challenges my beliefs.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I can manage my emotions under stress.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I communicate respectfully even when I disagree.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I feel confident providing emotional support to others.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
I am comfortable discussing confidential health topics.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
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Your Story, Motivation & Growth
We believe lived experience, reflection, and personal growth matter deeply in this work. These questions give you space to share your perspective, values, and experiences in your own words. Please answer thoughtfully and authentically.
Tell us about a time you learned from someone who was either older or younger. What helped you stay open?
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Describe a time when you had to pivot or adjust unexpectedly. What did you learn about how you handle change?
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What life experiences led you to birth work?
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What do you think will be your biggest strength as a doula?
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How do you typically respond when someone gives you constructive feedback?
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What challenges do you expect during training or practice?
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What does “being of service” mean to you?
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How do you see yourself impacting your community as a doula?
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Preparing for the Responsibilities of Training
Our training program requires commitment, communication, accountability, and consistency. These questions help us understand your current availability, support systems, and readiness to participate fully in both classroom and community-based learning experiences.
Are you employed or in school?
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Yes
No
Can you commit to the full training schedule?
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Yes
No
Do you have reliable transportation?
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Yes
No
Do you have consistent childcare (if applicable)
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Yes
No
Have you supported someone through pregnancy, birth, or postpartum?
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Yes
No
If conflict arises with a peer or instructor, how do you typically handle it?
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What helps you stay motivated when tasks become difficult?
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Capacity & Commitment
We value honesty and planning over perfection. Sharing challenges will not automatically disqualify you from consideration.
The Virtuous Doula Training Academy program is a 16-week training that includes coursework, skills labs, assignments, guest speakers, collaborative learning, and selective practicum opportunities. We understand applicants may also be balancing work, caregiving, school, and personal responsibilities. Please describe your current capacity to commit to the expectations of this program and any supports or challenges that may impact your participation.
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Emotional Awareness & Trauma-Informed Readiness
Trauma-informed care is a core pillar of our training philosophy. These questions help assess emotional awareness, empathy, and readiness to navigate sensitive conversations with care and professionalism.
Comfort discussing trauma, loss, racism, or mental health.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Awareness of how trauma shows up in birthwork.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Confidence navigating emotionally intense situations.
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
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Access, Support & Learning Needs
We are committed to creating an accessible and supportive learning environment. The information below helps us understand technology access, childcare needs, accommodations, dietary considerations, and other supports that may help you fully participate in the training program.
Do you have access to a computer for online sessions?
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Yes
No
Do you have reliable internet access?
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Yes
No
Do you need childcare for in-person sessions?
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Yes
No
List names and DOBs for any children needing childcare.
*
Dietary Restrictions
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Allergies (environmental or food)
*
Accommodations you would like us to be aware of
*
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Program Commitment & Financial Understanding
Please review the following statements carefully. These questions ensure all applicants understand the expectations related to attendance, professionalism, scholarship eligibility, participation, and financial responsibility within the program.
I understand that this program may be scholarship-funded.
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Yes
No
I understand that if I am not awarded scholarship funding, I may be responsible for tuition costs associated with training.
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Yes
No
I understand there are required attendance expectations.
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Yes
No
Will you be applying for a scholarship to cover tuition?
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Yes
No
I’m not sure
I understand I must maintain professionalism throughout the program.
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Yes
No
I agree to complete all assignments and requirements.
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Yes
No
I understand no refunds are provided once training begins (if applicable).
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Yes
No
I understand that scholarship-funded students must meet expectations to remain eligible.
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Yes
No
Scholarship Screening Question
Will you be applying for a scholarship to cover tuition
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Yes
No
I'm not sure
Briefly describe your need for scholarship support.
You do not need to share deeply personal details. Please share any financial, family, work, transportation, caregiving, or life circumstances that impact your ability to pay for training at this time.
*
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Acknowledgement & Agreement
Your signature acknowledges your understanding of the program expectations, participation requirements, scholarship guidelines (if applicable), and commitment to engaging respectfully and professionally throughout training.
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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