Mother Tree Diversity Scholarship Application offers a "Pay What You Can" sliding scale (with payment plan) option up to 100% (limited spots per training). This fund supports birth and postpartum training (step 1 to certification).

To be considered for this scholarship one must identify as Black, Indigenous or Person of Color, or LGBTQIA+ or r live in a rural Oregon County (outside the Metro Portland area)

This fund has been created by doulas paying it forward and grow our workforce!

First Name (As you wish for it to appear on your certificate) *

Last Name (As you wish for it to appear on your certificate) *

Preferred name or "nickname"

Pronouns *

Email *

Phone *

Street Address (where you may receive training materials) *

City *

State *

Postal code *

I wish to apply to attend the following trainings: *

BIRTH DOULA TRAINING ~ MEDICAID APPROVED $1100

POSTPARTUM DOULA TRAINING $950

THW TRACK: TRAUMA INFORMED CARE, COLLABORATIVE PRACTICE, HIPAA, CULTURAL RESPONSIVENESS $175

BUNDLED ALL OF THE ABOVE (BIRTH, POSTPARTUM THW) $1850

PAY WHAT YOU CAN: 1. What can you pay total for the desired classes? 2. Do you need a payment plan? 3. Do you need 100% scholarship (limited spots per class available). $50 fee required to submit roster for certification. *

I have already completed the following Birth Doula Training (Program, Location, Dates) -mark NA *

What cities and counties near you will you be able to serve as a Birth Doula? *

Race (racial identity): How do you identify your race, ethnicity, tribal affiliation, country of origin, or ancestry? *

Languages Spoken (primary + additional) *

What interests you in becoming a birth doula? (2-4 sentences) *

How do you see being a doula enhancing your professional goals? *

How do you see your role as a doula serving your community? *

In order to be considered for this scholarship, we ask that you be committed to serving Medicaid clients. The process to become eligible to bill Medicaid includes completing all of the state's requirements and applying to become a Traditional Health Worker certified Birth Doula with the Oregon Health Authority. We request you are committed to this process and agree to complete all necessary paperwork within a year of being trained. See details here: https://www.oregon.gov/oha/OEI/Pages/THW-Doula.aspx and https://communitysolutions.pacificsource.com/Base/DocumentContent/kDvFYMsa8ov7hqPzkdxd6EeLLKG_y_mY8Q6fph0sZ08JEyGodys5CCX3SNgEHZHN/Doula%20Certification%20Instructions

I... *

YES i commit to this process

NO I don't commit to this process

I have more questions.

What other life skills or professional experiences do you have that will support your doula work? *

Anything else you'd like to include for why this scholarship would be valuable to you? *

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