Idaho Midwifery Council
Membership Application
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Membership in the Idaho Midwifery Council runs from January 1 to
December 31 of the current year, with renewal due on January 1 of the
next year. Benefits of
membership include but are not limited to periodic newsletters, access
to statewide networking and discounts on IMC sponsored conferences and
workshops.
Contact
Information
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Name |
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Street Address |
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City, State, Zip Code |
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Home Phone |
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Work Phone |
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Cell Phone |
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Fax |
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E-Mail Address |
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Website address |
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| idahomidwives.org listing |
Include my listing on “Find a Midwife” page: ___ Yes ___ No |
| IMC Newsletter preference | ____ Email (preferred) ____ Printed |
Who are you
in Midwifery?
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___ CPM |
___ DEM |
___ Doula/CBE |
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___ CNM |
___ Student |
___ Other |
Membership
type and payment:
Current membership is January 1 – December 31.
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___ Voting member, open to midwives and student midwives |
$35 per year |
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___ Non-voting member |
$15 per year |
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Payment should be made out to Idaho Midwifery Council and may be submitted by: |
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___ Check |
___ Money Order |
___ Paypal, by online payment |
Submit
application
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Submit your completed application with payment: ___ by mail to Kendra Scarlett, 388 Coyote Way, Bonners Ferry, ID 83805 ___ by email to Kendra Scarlett at zfreen@nidaho.net.
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