Newlife International School of Midwifery
Mercy Maternity Center
Davao City, Philippines

APPLICATION FOR SHORT TERM INTENSIVE TRAINING PROGRAM

[THIS FORMAT IS A GUIDELINE. PLEASE USE ADDITIONAL PAPER AS NEEDED FOR ESSAY QUESTIONS]

GENERAL INFORMATION:

Date of Application:

Name:

Address:

Email Address:

Date of Birth:

Phone Number:

Family Status:

How did you hear about Newlife International and Mercy Maternity Center?

Preferred date of arrival in Davao:

Requested duration of stay in Davao:

EDUCATIONAL BACKGROUND:

Starting with High School please list from that time until present any education you have obtained. Please include name of school, courses taken and degrees awarded. If you are currently enrolled in a school please include that information as well.

ESSAY QUESTIONS:

Please answer the following questions as clearly and completely as possible.

1. What are your goals for midwifery training?

2. Why are you interested in midwifery?

3. What is your present/previous birth experience?

4. What will be your personal strengths as a midwife?

5. Why do you want to come to Newlife International / Mercy Maternity Center?

6. How is your health and stamina? Do you have any dietary restrictions? Medical conditions that would limit your activity?

7. Please tell us anything else about you that would be helpful for us to know.

REFERENCES:

Please request the following people to submit a character reference on your behalf. References may be mailed via email to: director@midwifeschool.org (A) Teacher or employer. (B) Friend or family member. The reference should include information about you, your character, whether or not they feel you would be qualified to serve in an overseas maternity clinic and any other information that would be beneficial to us. Please submit the names of the people you have requested to write these references with your application.