Student Application for Enrollment

Complete and submit the following application form. Once you click 'Submit,' follow the prompts to submit your $30 application fee through our website. Once we receive your application form and $30 application fee, you will be contacted by e-mail to schedule an admissions interview with one of our Administrative staff. We look forward to speaking with you! 

Name *
Name
Address *
Address
Phone *
Phone
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An official high school transcript or equivalent, sent directly from the granting institution, is required to complete enrollment. Please request that your transcript be sent directly to NMI, PO Box 128 Bristol VT 05443.
(optional) Do you have a disability for which you would like to apply for educational accommodation? If yes, you will be contacted by NMI administrative staff to discuss your situation further.
National Midwifery Institute is an equal opportunity employer and educational institution. There shall be no discrimination against any employee, applicant for employment or any student on any basis including actual or perceived sex, gender identity, race, color, marital status, ethnic origin, religion, age, sexual orientation, or disability. This non-discrimination policy applies to all educational policies and programs and to all terms and conditions of employment, which include (but are not limited to): recruitment, hiring, training, compensation, benefits, promotions, disciplinary actions and termination.
(optional) Are you of Hispanic or Latino Descent? (Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture)
NMI strives to be a leader in accessible, inclusive, socially just midwifery education. Your response to the following questions is entirely optional and will not be used for admitting purposes. We also ask these questions in order to gather data that we use to measure whether we are meeting the above goal.
(optional) Regardless of your answer to the prior questions, please check one or more of the following groups in which you consider yourself to be a member:
Have you attended Heart & Hands Intensives with Elizabeth Davis? *
If you have completed Beginning/Intermediate Heart & Hands, please enter your date of completion below.
If you have completed Beginning/Intermediate Heart & Hands, please enter your date of completion below.
If you have completed Advanced Heart & Hands, please enter your date of completion below.
If you have completed Advanced Heart & Hands, please enter your date of completion below.