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Enrollment

Doula Training Enrollment Form                                                             

(Required fields are in Gold)
Name:

 

Address:

 

City:

 

State:

 

Zip Code:

 

Country:

 

Phone Number:

 

Alternate #:

 

Email:
How I heard about Sierra Childbirth Institute

 

 

 

I am interested in attending the following

“Mothering the Mother” Doula Training Workshop(s):

(Please select from the following classes)

 

 

2008 Introduction to Childbirth

 

Tuition:  $145 in full or $45 deposit

with balance of $100 due at workshop

    

 Early Bird Special (Save $20)

               ~ To qualify, simply pay the deposit or total at least 3 weeks

                      prior to the date of your workshop: 

               $125 in full or $45 deposit,

               with balance of $80 due at workshop

 

 

 Fri. Feb. 22 ~ Grass Valley, CA

 Fri. March 28 ~ Santa Cruz, CA

 Fri. May 2 ~ Grass Valley, CA

 

 Fri. July 18 ~ Santa Cruz, CA

 Fri.  August 8 ~ Grass Valley, CA

 

2008 Doula Training 2-Day Intensive Workshop

 

Tuition:  $425 in full or $195 deposit 

                 with balance of $230 due at workshop

 

     Early Bird Special (Save $30 by paying early):

        ~ To qualify, simply pay the deposit or total at least 3 weeks

               prior to the start date of your workshop: 

               $395 in full or $195 deposit,

               with balance of $200 due at workshop

 

 

 February 23-24 ~ Grass Valley, CA

 

 March 29-30 ~ Santa Cruz, CA

 May 3-4 ~ Grass Valley, CA

 July 19-20 ~ Santa Cruz, CA

 August  9-10 ~ Grass Valley, CA

 

 

 

2008 Advanced Doula Training Workshop

 

Tuition:   $170 in full or $50 deposit

                  with balance of $120 due at workshop

 

     Early Bird Special (Save $20 by paying early):

         ~ To quality, simply pay the deposit or total at least 3 weeks

               prior to the date of your workshop: 

               $150 in full or $50 deposit,

               with balance of $100 due at workshop

 

Workshop dates for our Advanced Doula Training Workshops have not been scheduled yet.  Please check back with us in the spring. 

Cancellation Policy:

To cancel your registration and receive a refund, a written request must be postmarked 30 days prior to the workshop date.  A cancellation fee of 10% of the tuition is retained on all refund requests.  Written requests for refunds that result from extreme emergencies will be considered on a case-by-case basis up to 14 days after the first day of the course.  Following that time, no refunds will be processed.

 

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Payment Methods:

 

After submitting this enrollment form, you will be directed to a new page where you will be given the option to pay online with any major credit card or checking account.  

 

Or if you prefer, you can mail your payment to the address below.  To assure a reserved space, deposit is due within 2 weeks of registering for workshop.  Please make check or money order payable to Sierra Childbirth Institute with the workshop date and location written on your check.

 

Optional: If you do not wish to use the Submit button below to send us your above information online, you may instead print and mail this enrollment form with your payment.

 

Mail to:
Sierra Childbirth Institute ~ 12352 Sunshine Valley RoadGrass Valley, CA  95945

   
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