Childbirth Education Specialists

First fill out and submit our online enrollment form below. Then either mail in your deposit to 725 Christine Drive, Vacaville, CA 95687 or pay with a credit card or check online through PayPals. OR
Print our convenient enrollment form (this is a PDF document), fill it out and mail it, along with payment, to 725 Christine Drive, Vacaville, CA 95687.

If there's no workshop in your area, or not a time that fits your schedule, consider sponsoring a workshop. If you don't see the learning opportunity you are looking for on this form, please contact us.

Online Enrollment Form
* indicates a required field
*Select Workshops Check all workshop(s) and/or educational opportunities that apply. Select dates corresponding to Workshop(s) checked.		INTRODUCTORY DOULA TRAINING - $125 Requires $125 deposit
		DOULA CERTIFICATION WORKSHOP - $375 Requires $100 deposit

Continuing Education Units Select all for which you wish to receive credit.	ICEA DONA CABRN
Savings Offers valid only for Doula Certification Workshops.	Save $25 for early registration. Registration & deposit must be received at least 30 days prior to first day of Certification Workshop. Refer a friend. $25 discount per friend ($75 max.). You and friend(s) must attend the same workshop. Name(s) of friend(s):
*Total payment Discounts deducted from balance due, payable in full on first day of workshop.		Total deposit
*REFUND POLICY Deposits are non-refundable and non-transferable, unless the workshop is cancelled. If you pay in full in advance of the workshop and cannot attend, you must give at least 2 weeks advance notice to receive a refund (less your deposit). If you fail to give the required advance notice, you will forfeit the entire amount paid. Full refunds of enrollment fees are given if a workshop is cancelled by the instructor. Please note that travel expenses are not included or reimbursed under any circumstances. Refunds will be credited or mailed within 30 days. I understand and accept the terms of the refund policy.
*Name *Email Phone	*Complete mailing address Street City State Zip Code Country (optional)
Whom may we thank for referring you?
Comments or questions?
Make your check payable to Debbie Lavin and mail it to: 725 Christine Drive, Vacaville, CA 95687 A confirmation letter containing workshop details and directions to the workshop site will be sent upon receipt of deposit.

Please don't press the Submit button more than once. It may take a few moments to transfer your information. We appreciate your patience.

Childbirth Education Specialists 2007

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