JM Birth Consultants International

Promoting Family-Centered Maternity Care

1. Submit completed Registration Form.

2. Pay online with your Credit Card using PayPal or mail a check to the JMBC Program Coordinator - checks can be made out to JM Birth Consultants
 
3. Upon receiving the completed Registration Form, the JMBC Program Coordinator will mail you a confirmation letter.

Any questions regarding workshop content, registration process or deposit fees contact JMBC Program Coordinator:

Michele Peterson -  703-350-2056
3115 Budd Way
Alexandria, VA 22310

michele@jmbirthconsultants.com
DEPOSIT - Loss & Pregnancy Workshop (112.50 Plus $2 PayPal Fee)
$112.50
PAYMENT IN FULL - Loss & Pregnancy Workshop ($225 plus $7 PayPal Fee)
$225.00

First Name
Last Name
Company Name
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City
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Daytime Phone() -
Evening Phone() -
E-mail Address
Workshop Date & Location
Educational Background: [degree(s), Certification(s), etc.]
Volunteer activities and/or empolyment:
My questions/hopes & expectations/information needed:
Payment: (DEPOSIT-$112.50 or PAYMENT IN FULL-$225)
Payment Type (PayPal or Check)