Doulas of SCV AFFILIATE Membership
BEFORE COMPLETING THIS FORM, PLEASE READ THIS: 
Please complete this form to join Doulas of SCV if you are NOT a doula. This Affiliate Membership form is for perinatal professionals living in and serving the Santa Clarita Valley. Please read the Terms and Conditions of Affiliate Membership at the bottom of this form.
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Email *
Full name (First, Last) *
Today's date *
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Business Name *
Home Address (street address, city, state, zip) *
Business Address (if different than home address)
Cell Phone number *
Business Phone number (if different than cell)
Web Address
What type of perinatal professional are you? *
Tell us about your professional services and what certifications/licenses you hold *
Would you be interested in leading or co-leading any educational events for doulas or the public? *
What is your birthday? We want to celebrate you! *
Affiliate Memberships for Doulas of SCV will expire on December 31st each year. Any Affiliate Memberships that are not renewed during the membership renewal period will be removed from the website. In order to renew your membership, you will need to complete a Returning Affiliate Membership Form each year *
Have you read the Terms and Conditions for Affiliate Members Below? If so, please let us know you are in agreement with them. *
Questions? Comments? *
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