A Girl named Jimmie Perinatal Bereavement Scholarship application
Three Little Birds Co-Founders, Kristen & Brent Samuelson, are excited to announce the launch of our "A girl named Jimmie" scholarship for individuals interested in supporting perinatal bereavement!

The Samuelson's were thrust into the world of pregnancy and infant loss after experiencing the loss of their first born daughter, a girl named Jimmie Anne in 2014. A few months later, the Samuelson's experienced a near-fatal ectopic pregnancy. In both experiences, the medical professionals were not adequately trained in how to support the physical, emotional and spiritual toll of grief families experience which had a profound negative impact. This is what fueled the founding of our non-profit project, Three Little Birds Pregnancy and Infant Loss Support, which now serves more than 100 families registered as members of our nest, in addition to the 350+ families we have served bedside or through social media since our founding in 2016.

To further the mission of Three Little Birds and to shatter the stigmas associated with loss, we are dedicated to working closely with the medical community to bridge the gap between healthcare and humanity. But for the Samuelson's, this ultimately is a positive way for them to parent their babies from beyond the grave and be the change we wish to see in the world.

This scholarship will allow medical professionals/students, loss parents and advocates to support bereavement when working in the family building community through our Perinatal Bereavement Training Program. We are specifically looking for big-hearted individuals in Philadelphia, Southeastern PA and throughout the State of NJ to help expand our Bedside Bereavement Program and institute consistent peer led perinatal bereavement care where programs do not currently exist.

Applications are open rolling. If you are eligible, you will receive a promo code to use at registration. Limited scholarships are available. Please complete the form below.
אימייל *
First and last name
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Phone number we can text
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Scholarship application applying for:
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חובה
What is your experience with or interest in perinatal support?
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Tell us about yourself - age, education, interest in perinatal/women's health, anything about yourself you wish to share to set you apart from the rest :) Why are you applying for this scholarship/training?
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Do you know someone or have you yourself experienced perinatal loss (miscarriage, stillbirth, infant loss)?
Throughout our training, we will be viewing photos we have provided of babies who have passed away. This can be a trigger for many, especially loss patients. Are you comfortable with seeing and creating these images to bring comfort to families?
Our virtual training program is self-paced over six weeks. Please indicate which session you prefer to attend.
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Please indicate the area in which you live
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Please indicate the medical facility you work at or, if a volunteer, the closest hospital supporting birth that you may want to volunteer at through Three Little Birds.
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The scholarship reduces the tuition rate to $50 which covers administrative expenses. If chosen, can you commit to a $50 tax deductible donation to participate? You will not be disqualified from the scholarship if you cannot.
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We are asking our scholarship winners to participate as a volunteers supporting existing Bedside Bereavement Programs, as well as our planned expansion. This would involve meeting families at the hospital to encourage memory making, bonding and photography. Volunteers average one to two sessions per year.
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If you are a provider, would your hospital or care team be interested in a complimentary bereavement needs assessment? This one hour meeting with staff serves as a third party review of procedures, education, resources and comfort/support items. A report will be provided along with a proposal of how Three Little Birds can add value to your patients and staff.
ניקוי הבחירה
Please read and complete below:

Continuing Education Credits are not provided with this training at this time. Tuition is a tax-deductible donation that supports the mission of Three Little Birds and helps us keep our services free.
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Any other questions or comments?
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