Midwifery Mentorship Application

Please complete this form to apply to our midwifery mentorship program.

Our team will be in touch after we've reviewed your application.

Name
First Last
Pronouns
Email
Phone
Location
City State
How did you hear about the program?
- Website
- Social Media
- Another birth worker
- Manhattan Birth Mentor: Tanya/Sarah
Tell us about your current experience.
Tell us about your practice or where you are in your educational journey (if student)?*
What are you missing right now - in your practice? Education? Life?*
What type of support do you have in your life to support you through this mentorship program and the next stages of your life?*
What brought you to midwifery?*
What are you looking for in a mentorship program?*
What does community mean to you ?*
Which areas of your practice do you hope to expand/improve? 
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.

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