This form is divided in to two sections. The area directly below is for information you want shown on the register and will be
viewable by the public.
The bottom half of this form is for our records only and is not viewable by the public.
Your Full Name
(first and last name only)
Your Email Address
(for clients to conact you with)
Your Region
click on your state below and then
select your region within that state
In the box below type up to 5 places within your region you will travel to as a doula
(eg. towns, cities or suburbs)
Select Region - NSW
Blue Mountains
Central Coast
Central West
Far South Coast
Far West
The Hunter (Newcastle)
Illawarra (Wollongong)
Lord Howe Island
New England (N-West)
Murray
Mid North Coast
North West Slopes
Northern Rivers
Riverina
Sapphire Coast
Snowy Mountains
South Coast
Southern Highlands
Southern Tablelands
South West Slopes
Sydney
.
Select Region - TAS
Central Highlands
Midlands
West Coast
Your Areas within your Region
Select Region - WA
Gascoyne
Goldfields-Esperance
Great Southern
Kimberley
Mid West
Peel
Perth
Pilbara
South West
Wheatbelt
Christmas Island
Cocos (Keeling) Islands
Select Region - VIC
Bendigo Area
Gippsland
The Grampians
The Mallee
Melbourne
Mornington Peninsula
The Victorian Alps
Western District
The Wimmera
Yarra Valley
Select Region - QLD
Brisbane
Bundaberg, Coral & Country
Capricorn
Fraser Coast, South Burnett
Gladstone
Gold Coast
Mackay
Outback Queensland
SE Queensland
Southern Downs
Sunshine Coast
Toowoomba & D Downs
Torres Strait Islands
Townsville
Far North Queensland
Whitsunday
Select Region - A.C.T.
Canberra
A.C.T. Area
Select Region - NT
Arnhem Land
Central Australia
Top End
Select Region - SA
Adelaide Plains
Adelaide Hills/Mt Lofty
Barossa Valley
Copper Triangle
Eyre Peninsula
Far North
Fleurieu Peninsula
Flinders Ranges
Kangaroo Island
Limestone Coast
Mid North
Murraylands
Riverland
Yorke Peninsula
Your Home Phone
Your Mobile Phone
Your website
(if you have one)
http://www.
--------- In the area below, please type the information for our records only ---------
This information
will
not
be viewable by the public and
will not
be given to any other party. If some information is the same as above (Name, Email..etc) retype it below.
Do not
type "
same as above
"
Full Name
Email Address
Home Address
Home Phone
Mobile Phone
USA
UK
Australia
New Zealand
Canada
School of Doula Training
Email or phone of school/course
Year completed course
You must fill out both the top and bottom sections before sending this form
Home
Join the Register
Renew Registration
Become A Doula
Find A Doula
Role of the Doula
Role of the Register
FAQs
Contact Us
STEP 1: Online Form
STEP 2
: Declaration
STEP 3
: Pay Fee
Basic Education
Continuing Education
Role of the Register
Code of Conduct
Limits of Service
Standards of Service
Maintaining Registration
