ICEA Certification Program Enrollment Form

Completion of this enrollment form with full payment will constitute enrollment in the ICEA certification program(s) indicated. Within three weeks of receipt of this enrollment form, ICEA will send the program materials. Enrollment and membership fees are non-refundable and non-transferable.

Contact Information

First Name:MI:Last Name:
Address:
City:State:Zip:
Country:
Phone Number:
Email Address:

Membership

I am a current member of ICEA.
Verified by ICEA Main Office:
I am not currently an ICEA member, but wish to join at this time. ($75)

Certification Programs

Childbirth Educator Certification Program

Traditional ($100)
Experienced ($100)
Previously Certified - Optional Study Modules Purchase ($30)
Name of Prior Certification Organization:
Previously Certified ($0)
Name of Prior Certification Organization:

Doula Certification Program

ICCE ($100)
Non-ICCE ($100)

(New) Postpartum Doula Certification Program

($100)

(NEW) Prenatal Fitness Educator Program

($275 - Includes All Program Materials)

Payment

Card Type: Visa      Mastercard
Card Number:
Exp. Date: /
3 Digit CVN Code:
I agree to be charged the TOTAL amount from the above checked options.
"I support the natural process of childbirth and the right of the expectant parent to make informed choices based on knowledge of alternatives. As an ICEA certified educator I will work with other health care professionals and consumers to promote family-centered maternity care, breastfeeding, and parent-infant bonding. I advocate parental participation in childbirth and the avoidance of medical intervention in uncomplicated labors. I accept as my primary responsibility the preparation of expectant parents, both mentally and physically, to participate in an individually satisfying pregnancy, labor, birth and introduction to parenthood."