National College of Midwifery SIS and LMS Portal.Powered By Classe365

Getting Started

Head and Shoulders Photo

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.

Preferred First Name^*

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^*

LEGAL first name.

Middle Name or Initial

Legal Last Name^*

Your current legal last name.

Other Legal Names

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

Preferred Pronouns

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.

Date of Birth^*

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.

Permanent Street Address^*

This is your permanent mailing address.

City^*

State^*

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

Country^*

Country associated with your permanent mailing address.

Zip Code^*

Phone Number^*

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

PERSONAL Email^*

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.

Confirm you have read and understand the ASM Cost of Attendance Document.^*

I have read and understood the "ASM Cost of Attendance Document" and understand there is a per credit fee for academic courses in addition to the clinical audit fee.

https://docs.google.com/document/d/1HKuJxX_Mq44GSTbVEA9oXnJLQrMYI2UGcf0fQCFbICE/edit?usp=sharing

Confirm you have graduated from high school or have your GED.^*

State or Country You Plan to Start Your Midwifery Studies^*

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 info@midwiferycollege.edu to discuss your situation.

Create your NCM Email Address using the following format:^*

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

Preferred first name
Last initial
## (two numbers)
@midwiferycollege.edu

You can choose any two numbers to include in your email address
(Examples: MonicaB34@midwiferycollege.edu, TyronG78@midwiferycollege.edu)

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

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

Are you transferring in from another MEAC accredited program?^*

Please let us know how you heard about our program.

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

Are you a first generation college student?^*

Being a first-generation college student means that your parent(s) did not complete a 4-year college or university degree, regardless of other family members' level of education.

Is English your first language?^*

Do you live in a rural area?^*

In general, a rural area or a countryside is a geographic area that is located outside towns and cities. Typical rural areas have a low population density and small settlements. Agricultural areas and areas with forestry typically are described as rural.

Is becoming a midwife a first career for you?^*

Which categories describe you? ^*

Native American or Alaska Native Asian African/Black Hispanic; Latinx; or Spanish origin Middle Eastern or North African Native Hawaiian or Other Pacific Islander White Some other race; ethnicity; or origin; I will specify more below.

Select all that apply to you:

If you chose above, "Native American" or "Some other race, ethnicity, or origin," please specify your tribal affiliation or race/ethnicity/origin here (or N/A).^*

Current Employment Status: How many hours you work for pay outside of your midwifery apprenticeship. ^*

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

Other responsibilities: In addition to my apprenticeship, I also have significant care-giving responsibilities for someone living in my home (other than my own children).^*

What is the most important support that you have had or are receiving currently?^*

What type of support do you feel would be most helpful for you to complete your degree?^*

The National College of Midwifery prohibits discrimination, harassment, retaliation, or discipline against any NCM community member or group including but not limited to the board of directors, volunteers, faculty, staff, contractors, prospective or current student on the basis of their actual, implied or perceived; because of race; color; national or ethnic origin or ancestry; religion or creed; age, sex, gender, gender identity or expression, including transgender identity; sexual orientation; marital status; familial status; age; ability/disability; genetic information; economic status, formal education, language, citizenship status, veteran status, genetic and/or ancestry information, political affiliation or other identities, including any other protected category under federal, state or local law. All personnel who are responsible for recruitment, admissions, hiring and promoting and for the development and implementation of college programs are entrusted to hold up this standard and to respond promptly and appropriately to any concerns that are brought to their attention.

Application Date and Program

Today's Date^*

Student Type^*

Program^*

Anticipated Preceptor First and Last Name^*

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.

Anticipated Preceptor Email^*

Fees

Mandatory Fees
	Application	100
	Total	100.00

Please make sure you have a preceptor lined up prior to applying. The application fee is NON-REFUNDABLE and is valid for 6 months.

(If you have not finalized enrollment within 6 months, this application will be archived and you will need to reapply, and pay another application fee.)

Scholarship applicants must first submit this application. The clinical audit fee may be partially waived as part of a scholarship award.

Non-scholarship recipients must pay the full clinical audit fee of $4,500 to enroll. Alumni and NCM Clinical Preceptors will be given a discount code for course tuition costs paid after the clinical audit fee.

NOTE: You cannot be admitted into the ASM program unless you are 16 years of age, have earned your high school diploma/ GED or equivalent, and plan to study in a state or country authorized by NCM.

Clicking the submit button will constitute your electronic signature and certifies that all information is true and correct to the best of your knowledge.

You will receive an email with instructions about the next step in the enrollment process. If you do not receive this please check your junk mail or email info@midwiferycollege.edu

Please accept the terms & conditions to submit this form.

Associate's of Science in Midwifery Student Application

Getting Started

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

Application Date and Program

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