When Survivors Give Birth - live virtual training 2021

Please complete the registration form below for the live virtual workshop, When Survivors Give Birth with presenter, Jenn Fontaine.

Date: Monday July 19th, 2021

Time: Zoom room opens at 8.45am.
Workshop runs from 9:00am (Australian Eastern Time) – 5.30pm (there will be several scheduled breaks throughout the day)

Cost: $250

Order your copy of Penny Simkin & Phyllis Klaus' book, When Survivors Give Birth when you register for the workshop and SAVE! Books cost $65 (includes GST and shipping within Australia) when you order at the time of registration.

Name (as you would like it to appear on your certificate of attendance)
Your certificate will be emailed to you following the workshop. Name (as you would like it to appear on your certificate of attendance)
Your certificate will be emailed to you following the workshop. * First Last
Organisation or Business that you are representing
Email address *
Contact phone number *
Your Profession (tick all that apply) *

Your Profession (tick all that apply) Midwife / Nurse Midwife Doula Student Midwife Childbirth Educator RN GP OB-GYN Counsellor Psychologist Psychiatrist Social Worker Community Health Worker Other Other
How did you hear about this training?
Pre-order a copy of Penny Simkin & Phyllis Klaus' book, When Survivors Give Birth and SAVE!
Your copy will be mailed to you. The book costs $65 (includes GST and shipping within Australia). *

Pre-order a copy of Penny Simkin & Phyllis Klaus' book, When Survivors Give Birth and SAVE!
Your copy will be mailed to you. The book costs $65 (includes GST and shipping within Australia). YES, I would like to pre-order a copy of When Survivors Give Birth NO, I just wish to pay for the workshop
If you would like to pre-order more than one copy of When Survivors Give Birth, please indicate below how many copies (in total) you would like to order.
If you are ordering a copy of When Survivors Give Birth, please enter your postal address below:
Please note: We can only mail within Australia. If you are ordering a copy of When Survivors Give Birth, please enter your postal address below:
Please note: We can only mail within Australia.
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Do you have a special discount code? Please enter it in the box below.
If you are a student midwife, please upload a copy of your student ID below.
If you are a student midwife, please upload a copy of your student ID:

Attach Files
Please tick the box below if you would like to be notified of future events and workshops. Your privacy is important to us and we will never share your details with anyone.

Please tick the box below if you would like to be notified of future events and workshops. Your privacy is important to us and we will never share your details with anyone.