Associate's of Science in Midwifery Student Application

Thank you for your interest in the National College of Midwifery!

This application is for our Associate of Science in Midwifery program,
which has both ACADEMIC (online classes) and CLINICAL (community-based apprenticeship) components.  

This form must be completed in one sitting and cannot be saved to be completed later. It will take approximately 5 minutes to complete.

- If you already have a community-based apprenticeship lined up with a clinical preceptor and are ready to do BOTH the academic and clinical components of your training, please proceed with this application. 

- However, if you do not have a clinical preceptor lined up, you cannot apply as a degree student yet. There may be another route for you!  Use this link for more information on many ways to engage with NCM's curriculum:

This form is the first step in the application process.

It requires a non-refundable electronic payment of the application fee of $100 by debit, credit card, or paypal upon submission.

Once you have completed this form and paid the application fee, within 1-2 days you will receive information on proceeding with the second step of the application process, which requires proof of completion of the Student Orientation Course (this course will take several hours and will give you important information on NCM's unique model).

The third step will request further information from you, require a copy of your high school diploma/GED, and generate a contract between you and your community-based clinical preceptor.  This third step will also need to be done in one sitting, and requires payment of the full clinical audit fee upon submission.  

(For information on scholarships:; 
Information on cost of attendance:


Thank you!

Getting Started

This is used as your profile picture and can be updated later. This image is used to personalize the online experience and has no bearing on admissions. It will also be used if you ever require a student ID to be generated.

Your PREFERRED first name.
NOTE: this will be used to create your email account with the college and will be how we address correspondence to you. Your LEGAL first name will be used on any official transcripts, diplomas, etc.

LEGAL first name.

Your current legal last name.

Please list any other legal names (associated with name change due to adoption, marriage, or other legal name change)

A preferred pronoun is a pronoun an individual chooses to identify with and would prefer others use when talking to or about that individual. It is the pronoun that a person uses for themself.

ASM students must be 16 when they begin the program. Use the calendar or type in your date of birth (MM-DD-YYYY). To use the calendar, double click on the month at the top to access your year, month and date of birth.

This is your permanent mailing address.

This is the state that is associated with your permanent mailing address. If not listed select -- at the top of the list.

Country associated with your permanent mailing address.

Best number to contact you at.
Please input only numbers. (International numbers should include country code without parenthesis.)

This is your personal email address where you will receive information about the next step in your application process. It will also be used as a backup email for your communications with the College once your NCM email address is established.

If your planned location is not on this list, NCM does not have the authorization to have students in this location. Please contact the office at to discuss your situation.

Please create your NCM email address using the following NCM email FORMAT:

Preferred first name
Last initial
## (two numbers)

You can choose any two numbers to include in your email address

Please type your desired email address in full, including the "".

NCM reserves the right to change your desired email during the enrollment process.

OPTIONAL: Demographics (your answers do not affect your application, but do help NCM secure funding to continue to make midwifery education as accessible as possible)

Select all that apply to you:

How many hours you work for pay outside of your midwifery apprenticeship.

Application Date and Program

You will be required to submit to NCM your active NCM community-based clinical faculty member in the last step of enrollment. If you put the preceptor's name and email address you believe you will be working with, we will send them an email with more information on either becoming a clinical faculty member or how to check their preceptor status with the College.
You CANNOT complete the final step of enrollment in NCM without an active NCM Preceptor.

Mandatory Fees
Application 100.00
Total 100.00

Upload Image

To crop this image, drag a region below and then click "Save Image"