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
Select your county within your region on the right. If you are close to the border of a certain region you may wish to choose more than one
Select County Within England
Bedfordshire
Berkshire
Buckinghamshire
Cambridgeshire
Cheshire
Cornwall
Cumberland
Derbyshire
Devon
Dorset
Durham
Essex
Gloucestershire
Hampshire
Herefordshire
Hertfordshire
Huntingdonshire
Kent
Lancashire
Leicestershire
Lincolnshire
Middlesex
Norfolk
Northamptonshire
Northumberland
Nottinghamshire
Oxfordshire
Rutland
Shropshire
Somerset
Staffordshire
Suffolk
Surrey
Sussex
Warwickshire
Westmorland
Wiltshire
Worcestershire
Yorkshire
North Riding
East Riding
West Riding
York
Select County Within Scotland
Aberdeenshire
Angus/Forfarshire
Argyllshire
Ayrshire
Banffshire
Berwickshire
Buteshire
Cromartyshire
Caithness
Clackmannanshire
Dumfriesshire
Dunbartonshire/Dumbartonshire
East Lothian/Haddingtonshire
Fife
Inverness-shire
Kincardineshire
Kinross-shire
Kirkcudbrightshire
Lanarkshire
Midlothian/Edinburghshire
Morayshire
Nairnshire
Orkney
Peeblesshire
Perthshire
Renfrewshire
Ross-shire
Roxburghshire
Selkirkshire
Shetland
Stirlingshire
Sutherland
West Lothian/Linlithgowshire
Wigtownshire
Select County Within Wales
Anglesey/Sir Fon
Brecknockshire/Sir Frycheiniog
Caernarfonshire/Sir Gaernarfon
Carmarthenshire/Sir Gaerfyrddin
Cardiganshire/Ceredigion
Denbighshire/Sir Ddinbych
Flintshire/Sir Fflint
Glamorgan/Morgannwg
Merioneth/Meirionnydd
Monmouthshire/Sir Fynwy
Montgomeryshire/Sir Drefaldwyn
Pembrokeshire/Sir Benfro
Radnorshire/Sir Faesyfed
In the box below type up to 5 places within your region you will travel to as a doula
(eg. towns, cities or suburbs)
.
Your Areas within your Region
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
