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educator training Intake Form
We are so very much looking forward to joining you!
Please take a few minutes to read the Terms of Service and fill out the form below:
Click here to Read the terms of service
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Indicates required field
Name
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First
Last
Email
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Phone Number
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Your Pronouns
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What town/city do you reside in?
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Have you taken My Powerful Birth for Professionals?
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Yes
No, but I am registered before this training.
No
What field of work are you in ?
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Doula (birth, full-spectrum, Postpartum, End of Life)
Midwife/ Nurse
Doctor
Registered Counsellor
Naturopath
Therapist
Other Allied Wellness professional
Check all that apply
What business are you joining us from?
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Where do you live and what area do you want to teach in/do you teach in (Our licence is available for in person classes).
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What is your intention of taking this class?
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To expand my knowledge
To elevate my current curriculum
To purchase a license and teach MPB
Other
Are you already and educator? If so, what curriculum do you use? where did you get your certificate from?
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Are you interest in becoming an educator for My Powerful Birth?
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Where did you hear about us?
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Instagram
Facebook
Google
Other Doula/Midwife/Allied-health professional
Other
I have read and agree to the Terms of Service.
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Yes I agree
No I do not agree
Click button above to read the Terms of Service
I agree to receiving marketing and promotional materials
Submit
Home
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Our Team
Become an Educator
Contact