Discernment Class Application - Momdoulary Death & Mourning Doula Training Program

Application Form

Application Instructions
Your full name *
Email *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone *
Related Training Or Experience *
Please share with us any related training or experience you have which is in any way related to this industry.
How Long Have You Been Considering Becoming a Death or Mourning Doula? *
What draws you to this field of work? Tell us a little bit about your interest? *
What concerns or doubts do you have about pursuing this as a career path at this time? *
Tell us about your experience with Death or Grief. Have you ever been present when someone (or a pet) has died? How has it impacted you? *
How recently have you experienced loss, and how did it impact you? Was it someone close to you? *
Feel free to ask any questions here: *
By clicking below, I attest to the following: *
I understand that Momdoulary, LLC, does not discriminate, and celebrates diversity; however I also understand that they discourage pursuing a major life change in the first six months following a loss, unless this is a path I've already been on. I also acknowledge that I understand that admission to this class does not guarantee admission to the six-in-one training; that if I'm under treatment or have been diagnosed with mental health issues, it is suggested I consult with my care provider before pursuing the main training program, as the exercises can be very intense; I also acknowledge that I understand the course fee is non-refundable, and that Enrollment Agreement terms supersede those of Paypal. I also understand that the fee for Enrollment in the Discernment class may be credited toward attendance of the six-in-one training session (if I meet admission requirements) if I enroll within 18 months of the start date of the Discernment class. I hereby state I agree with all of these statements:I agree
Which date are you applying for? *

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