CE Workshop Listing Request Continuing Education Workshop Listing Name* First Last Email* Workshop Approval Code* Acknowledgements* Select All I acknowledge that I checked the DONA International website for workshop listing(s) and communicated with any trainers hosting a workshop in close proximity of time and distance to my proposed workshop, to inform and connect with the aforementioned trainer. I further acknowledge that I am not required to gain permission from a trainer hosting a training in close proximity of time and distance with my own proposed training. I acknowledge that my roster will be submitted 24hrs before the start of my workshop to dona.org/trainerroster/ and within two weeks of the completion of the workshop. I further acknowledge that my evaluation will be sent directly to my workshop participants at least twice within one (1) week after the completion of the workshop from either dona.org/birthworkshopeval or dona.org/postpartumworkshopeval. Contact First & Last Name Contact Phone Number Your City/State or City/Providence* Contact Email Website Workshop DetailsName of Continuing Education Workshop* Public/Private*Publish to DONA.org (Public Listing $25)Do not publish to DONA.org (Private Workshop $0)If you choose Public you will be directed to the PayPal payment page after you click submit.Location of Continuing Education Workshop* Type of Continuing Education Workshop*Select Workshop TypeBirth Doula Continuing Education TrainingPostpartum Doula Continuing Education TrainingDates of Continuing Education Workshop* Include Month days, and year Ex: February 4 – 5, 2022Special Content/Population Description: Examples: “For Healthcare Professionals – 18 Nursing CEUs” OR “Workshop focused on Black community support”.Location Type for Workshop*Select Location TypeIn-PersonVirtualHybridIn-Person Trainer Waiver* The Trainer acknowledges that in-person events involve risk of injury or sickness, including sickness from COVID-19 and similar viruses.The Trainer, on their own behalf and on behalf of their heirs and assigns, agrees to waive and hold DONA International and their representatives harmless from and against any claims, damages or expenses arising from the in-person event offered by Trainer, including but not limited to sickness or death arising from COVID-19 or similar viruses.Payment SubmissionTotal $0.00 Payment MethodPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name DONA International has a no-refund policy. All transactions are subject to PayPal policies. EmailThis field is for validation purposes and should be left unchanged.
