Idaho Midwifery Council Membership Application

Please note that this page is under construction, so bare with us while we work out the kinks.  If you need to apply copy and paste to another page and print out, thank you!

Membership in the Idaho Midwifery Council runs from January 1 to December 31 of the current year, with renewal due on January 1 of the next year.  Benefits of membership include but are not limited to periodic newsletters, access to statewide networking and discounts on IMC sponsored conferences and workshops.

If you are a currently licensed Idaho midwife and would like to be listed on the “Find a Midwife” page on this site, your annual fee is $80.

Name:

Street Address:

City, State, Zip

Home Phone Number:

Work Number:

Cell Number:

Fax Number:

E-mail:

Website:

Idahomidwives.org/find a midwife.  Include me on this page     ___ Yes     ____ No

IMC newsletter preference    ____ e-mailed (preferred)     ____ mailed

 

Who are you in Midwifery

___   Licensed midwife  (any midwife licensed in Idaho, in good standing, who has paid current dues and has voting privileges in all general membership decisions.

___   Certified Nurse Midwife  (any CNM licensed in Idaho, in good standing, who has paid current dues and has voting privileges in all general membership decisions.

___   Student midwife  (any student enrolled in midwifery education or apprenticeship in good standing who has paid dues, does not have voting privileges, but is encouraged to be on committees and take an active role in association activities)

___   Associate member  (any vendor, other medical professional, or family member in good standing who has paid current dues but does not have voting privileges or participate in council decisions)

 

 

Membership type and payment:  Current membership is January 1 – December 31.

____  Licensed Midwife  WITH listing  on “Find a Midwife” page  $80 per year

____   Licensed Midwife, no web listing  $35 per year

____   Student Midwife  $15 per year

____   Associate member  $15 per year

 

 

Payment should be made out to Idaho Midwifery Council and may be submitted by

____   Check

____   Money order

 

Submit Application

Submit your completed application with payment:

___   By mail to Lori Sabin, 7084 Ash St., Bonners Ferry, ID  83805

___   By email to Lori Sabin, CPM, LM at sabin.lori@yahoo.com
If you would like to be listed on “Find a Midwife” page, please send your practice info to sabin.lori@yahoo.com

There is a $2.00 convenience fee for using paypal


Type of Membership