ACNM WA - BIPOC Member Fee Waiver

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As a part of our ongoing commitment to EDI work, the WA Affiliate will cover the state affiliate membership fee for BIPOC midwives and student midwifes. Fill out the following form and we will send you the application fee via Venmo. For questions- contact us at acnmwashington@gmail.com

Full Name

I am a...

Midwife

Student Midwife

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Email Address (please use school email if you are a student)

Midwifery Program (students only)

Venmo Account (email acnmwashington@gmail.com for other options if you do not have Venmo)

WA Affiliate Mailing List

YES- I would like to be added to the WA Affiliate mailing list (optional)

NO- I would not like to be added to the mailing list

Submit

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