Mentorship Program Application

Name

First Last

Pronouns

Email

Phone

Location

City State

How did you hear about the program?

Website
Social Media
Mentor Program Alum
Manhattan Birth Mentor

Which program are you applying to?

Year 1: Starting Your Practice
Year 2: Advancing Your Practice
Not sure, can you suggest a placement for me?

Tell us about your previous professional experience.

What brought you to birth work?

Please describe any previous doula training(s):

Please describe your practice as it stands now:

What are your goals for the next 2-3 years?

What are you looking for in a mentorship program?

Tell us about something you’ve set out to do and completed to the best of your ability—a challenge, a dream, or a goal.

Which areas of your practice do you hope to expand/improve?

Integrative Lactation + Feeding Specialist Program

Are you interested in joining our 10-week ILFS program next summer? Let us know!

Yes
No
I already took the program

Scholarship

Manhattan Birth has a scholarship fund available to promising BIPOC, LGBTQIAP+, or those doulas who identify as a member of a marginalized community. Is this something you’re interested in applying for?

Yes
No

Please describe how a scholarship to the Manhattan Birth Mentor Program would benefit you at this time.

We may contact you for an interview.