Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone

(###)

###

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Cellphone

(###)

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Fax (if applicable)

(###)

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Scheduled Date (must be within the next 12 months) *

MM

DD

YYYY

Please submit the following documents by email to education@novascotiadoulas.org *

Please make sure to write "Krista Donnelly Scholarship Application" as the title of your email when providing your supporting documents (see the bottom of this form). Make sure to include your Contact Information in the body of the email when you submit your documents. All documents should be received before October 13th, 2017 at 11:59pm. Your application will only be considered for this award once all of the documents have been received.

If applicable, please attach any event related documents that may strengthen your application (brochures, flyer, etc.).

Attach proof of your registration/enrollment to the event. (If your participation to the event is contingent on receiving funding, please write a short letter explaining your situation)

Proof of enrolment in a doula program OR a letter attesting to you work/volunteer work as a doula

Attach current resume or curriculum vitae.

Attach a 750-word statement explaining the importance of the knowledge gained during the event, how it will benefit you as a doula and how it will be used to serve communities in Nova Scotia. Please include three (3) ways by which you will share your newly gained knowledge with the NSDA and your community.

Attach a 250-word statement outlining your past, current and future contributions to the NSDA.