Scholarship Opportunity Lactation Educator Counselor Course

Scholarship Opportunity Lactation Educator Counselor Course

2011-11-07T22:10:41+00:00

Scholarship Application for Lactation Educator Course

Name:­­­­­­­­­­­­­­­­­­________________________________________________________________________
Last First

Contact Information:
Cell Phone___________________­­­_______ Home Phone_______________________________
Email______________________________
Address____________________________________________________­­­­­­­­­­­­­­­­__________________

Education:
College (including degrees earned, i.e., RN, BS)_____________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Other coursework:____________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Work Experiences:
____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________

Professional Affiliations:
__________________________________________________________________________________________________________________________________________________________________________

Honors:
__________________________________________________________________________________________________________________________________________________________________________

Please explain your plans for the future and how becoming a Lactation Educator will fit into these plans:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please use additional pages as needed. Email application as an attachment to kim.elkins@sdarc.org or fax to 858 309-1286 attention Kim Elkins.

(Copy and paste into a WORD DOCUMENT and email to Kim Elkins)

About the Author:

Leonard is a website designer and graphic designer for the North Park Group. He has been working with SDCBC for the past year on developing the website.