BIPOC Scholarship Application — Guided By Grace Doulas

Submitting Your Application

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1 Applicant Information

Full Legal Name *

Email Address *

Phone Number *

Certification Track *

2 Community or Professional Reference

Please provide one reference (mentor, elder, fellow birth worker, community leader, or client) who can vouch for your character and commitment.

Reference Full Name *

Relationship / Role *

Reference Contact (Phone or Email) *

3 Your Calling & Community Service

Your Story & Community Commitment * Tell us about your calling to birth work. How will this certification support your practice and the families you serve? (Minimum 200 characters)

0 / 200 characters minimum

4 Professional Integrity & Ethical Reciprocity

Demonstration of Integrity & Respect for Educators * Guided By Grace is an independent, woman-of-color-owned small business self-funding this scholarship. What does ethical reciprocity mean to you, and how do you handle communication and problem-solving if you face hurdles during your study? (Minimum 100 characters)

0 / 100 characters minimum

Guided By Grace Honor Code & Agreements

Intellectual Property Protection: I acknowledge that all curriculum, clinical guides, billing templates, video/audio modules, and materials are proprietary to Guided By Grace. I agree never to copy, share, distribute, resell, or claim them as my own. *

Good-Faith Communication: I understand that scholarship funding is a community investment. If I encounter any technical, personal, or administrative questions, I commit to communicating directly and respectfully with Guided By Grace administration to resolve them in good faith. *

Dedicated Seat Stewardship: I recognize that receiving a scholarship seat is a privilege that utilizes dedicated community funds. I confirm that I am applying honestly, in good faith, and with full intention to complete the program ethically. *

Community Engagement: I commit to joining our student community and actively engaging with fellow birth workers and instructors. *

12-Month Completion: I commit to completing the certification coursework within 12 months. *

BIPOC Scholarship Program

Submitting Your Application