NCIM Supporter Form - Canadian Association of Midwives

The National Council of Indigenous Midwives is committed to growing Indigenous midwifery and is therefore happy to provide information and resources to aspiring Indigenous midwives, individuals and organizations involved in Indigenous birth work, and Indigenous midwives from jurisdictions other than Canada. We welcome interested individuals and organizations to become supportive members.

Supporter Membership

Membership Amount *

$100

$120

$140

$160

$180

$200

Other amount

Minimum amount is $100.00

Other Amount

Total Amount

On Behalf of an Organization

On Behalf Of Organization

Organization Name *

Phone *

Email *

Street Address *

City *

Postal Code *

Country *

State/Province *

Personal Details

First Name *

Last Name *

Email *

Home Phone

Work Phone

Mobile Phone

Street Address

Supplementary Address

City

Country

Province

Postal Code

What is your age? *

Help us get to know you!

Please indicate your personal/organization's involvement or interest in Indigenous midwifery.

If applicable, please share the mission and values of your organization.

Preferred Communication Method

Phone
Email
Postal Mail
SMS

Privacy Policy

The National Council of Indigenous Midwives (NCIM) and the Canadian Association of Midwives (CAM/ACSF) values the privacy of our members and those who visit our website. We are committed to protecting the privacy, confidentiality, accuracy and security of personal information that we collect, use, retain and disclose in the course of carrying out our activities and providing services.

Using the principle of what a reasonable person would consider appropriate in the circumstances, NCIM and CAM/ACSF recognizes the importance of keeping personal information confidential using reasonable safeguards and limited to that which is necessary for the purpose for which it is collected. Names, addresses and other personal information held by NCIM and CAM/ACSF will not be given to individuals, organizations or corporations outside NCIM and CAM/ACSF at any time for any reason except with consent of the individual member or as required by law or allowed under the Federal Personal Information Protection and Electronic documents Act (PIPEDA).

Cancellation policy

There will be no reimbursement for cancellation of NCIM Supportive Membership.

Required *

Agree. I have read and accept the Privacy and Cancellation Policies.

Become a NCIM Supporter

Privacy Policy

Cancellation policy

Join our public mailing list

Join our public mailing list