Association of Texas Midwives
Midwifery Training Program
P.O. Box 887 Elmendorf TX 78112
ATM Midwifery Training Program
Application Packet
Table of Contents
Requirements 2
Qualities and Requirements of the Midwifery Student 2
ATM Midwifery Training Program Honor Code 3
Application Instructions 5
Additional Information 5
Contact Information 5
ATM Midwifery Training Program Refund Policy 6
Enrollment Deadlines 6
Application Checklist 7
Application for Enrollment 8
Section 1: Personal and Demographic Data 8
Section 2: Background Information 8
Section 3: Beliefs, Values, and Intent 9
Section 4: Essay 10
Section 5: Letters of Recommendation Information 10
Student Financial Agreement 1
Permission to Release Test Scores 4
Readiness-Commitment Survey 6
Letter of Recommendation 10
432-664-8845 Application for Enrollment EA-2016-3 Page 11 of 21
Table of Contents
Association of Texas Midwives
Midwifery Training Program
P.O. Box 887 Elmendorf TX 78112
ATM Midwifery Training Program
Application Packet
Dear applicant,
Thank you for applying to the ATM Midwifery Training Program (ATMMTP.) While extremely rewarding, midwifery is a demanding career with a great deal of responsibility; be prepared to devote a significant amount of time over the next 3 - 5 years to your education. Education is completed via a variety of methods, including distance, classroom, and competency based learning and demonstration.
Requirements
Requirements for enrollment are:
· Must be at least 18 years of age
· Must have a minimum of high school or equivalent education
· Demonstrate academic readiness (see list of options in the application checklist)
· Must have current healthcare provider CPR
· Must have a valid driver’s license
· Must be a student member of the Association of Texas Midwives (ATM)
http://www.texasmidwives.com/memberapp.asp
Not every person is well-suited for the demands of midwifery. Take note of the following statements:
Qualities and Requirements of the Midwifery Student
Midwifery is a physically, emotionally, and psychologically demanding profession.
You must have sufficient use of all cognitive, sensory and motor abilities to properly evaluate and care for mothers and babies. This includes, but is not limited to:
· Good interpersonal skills; being able to develop rapport and positive interactions with clients, midwives, and other care providers
· Able to learn to conduct basic office lab procedures
· Learn to perform clinical care activities such as palpation, auscultation, percussion and evaluation of physical findings
· Analyze and synthesize information to problem solve and reach diagnostic and therapeutic judgments
· Communicate with accuracy, clarity and sensitivity both verbally and in writing
· Learn to respond to emergency situations with quick and appropriate actions
· Be able to receive and acknowledge evaluation and respond appropriately
ATM Midwifery Training Program Honor Code
The ATM Midwifery Training Program believes that there are multiple methods of effective learning, including collaboration with one or more peers. However, in most instances it is critical that each student read and complete the assignments herself. It is rare that someone would learn best by being given the answer. The purpose of this code is to give students a better understanding of when discussion or collaboration with another student is acceptable, and when it could be considered cheating. Students will be encouraged to contact administrative staff if they are unsure if something might be considered cheating.
· My answers to homework, quizzes and exams will be my own work (except for assignments that explicitly permit collaboration).
· I will not make solutions to homework, quizzes or exams available to anyone else. This includes both solutions written by me, as well as any official solutions provided by the course staff.
· I will not engage in any other activities that will dishonestly improve my results or dishonestly improve/hurt the results of others.
Important Definitions:
Help: Helping another person to find the answer without giving them the answer; assisting one to understand the answer he/she found
· Explaining a difficult concept to another student
· Say, “Look in Chapter 7 in Varney.”
· Asking a confused student leading questions to provide direction for learning
Collaboration: The act of one or more people working together in order to achieve something; working with others to achieve shared goals; a joint effort of multiple individuals or workgroups to achieve a task or project; working together to find an answer
· Group projects
· Directions say collaboration is permissible, encouraged, or required
Generally, collaboration is not allowed on homework assignments. If you are unsure about any situation, ask the staff!
Plagiarizing: Representing the words, ideas or work of another person as one’s own and not offering proper citation of the source
Cheating:
· Giving or receiving, prior to an examination, any unauthorized information concerning the content of that examination
· Referring to or displaying any unauthorized materials inside or outside of the examination room during the course of an examination; this would include looking up answers to questions during an online test if it has been designated a “closed-book” test
· Communicating during an examination in any manner with any unauthorized person concerning the examination or any part of it
· Giving or receiving substantive aid during the course of an examination
· Commencing an examination before the stipulated time or continuing to work on an examination after the announced conclusion of the examination period
· Taking, converting, or concealing any property related to the preparation or completion of assignments, research or examination
· Submitting the same written work to fulfill the requirements for more than one course.
Application Instructions
Download the application packet and save it to your computer. Reopen the file from the location where you saved it, and then complete all sections on your computer by typing your answers in the underlined areas in the table, or “clicking” on the appropriate check boxes. Save your work and then print. Sign the financial agreement, NARM test results release, and the “Readiness” survey. Mail the original with all required documents (see checklist.) It is not necessary to mail pages 1 – 6. Please do not mail certified mail. Mail is usually picked up after-hours; requiring a signature will cause a delay in receipt and processing.
The ATMMTP requires two letters of recommendation from non-family individuals who have personal knowledge of the applicant and can attest to their character, educational experience and potential to succeed. The letters must be submitted to the Course Coordinator using the included ATMMTP form before enrollment can be completed. You will provide a list of names and contact information for each person from whom you have requested a letter of recommendation. (Section 5 of application.)
We suggest that you ask up to four individuals to send recommendations and provide each a stamped envelope addressed to the ATMMP. While the ATMMTP may contact respondents to clarify or ask for additional information, it is not the responsibility of the ATMMTP to follow-up when letters are not received.
Additional Information
The program is to be completed (academics and clinical training) within 5 years of enrollment. The ATMMTP is not responsible for students who do not complete the program within this time frame and will offer no refund other than those outlined in the Financial Agreement. Students who fail to finish in the allotted time will still be responsible for the financial arrangements in the Financial Agreement. The ATMMTP is not responsible for arranging preceptors. Securing an apprenticeship may be difficult. The ATMMTP will provide a list of current approved preceptors and it will be the student’s responsibility to make acceptable arrangements for clinical training.
Out of state students selecting the academics only portion of the course must be approved by the Course Coordinator. Please contact the ATMMTP office for further instructions.
Contact Information
Please feel free to contact the ATM Course Coordinator if you have questions. You may call 432-664-8845 or email:
ATM Midwifery Training Program Refund Policy
Effective 12/1/14
Refund Policy:
Pay Pal fees and student membership dues are not refundable.
Application fee is not refundable[1] after the initial 3 day period.
The following refund policy schedule includes tuition of the first module, Introduction to Midwifery. If an applicant pays future module tuition at the time of enrollment all tuition for those modules will be refunded.
Prior to enrollment completion:
· Request for refund immediately - within 3 days of application submission based on postmark: full refund of both tuition and application fee
· Request to have application withdrawn after 3 days and prior to mailing of program materials to the student: full refund of tuition (not application fee)
After enrollment processed and materials mailed (based on date shown on USPS priority mail receipt) or emailed (per date of email):
· Request for withdrawal within 14 days of program materials being mailed, and all materials returned in original condition: 85% refund
· Request for withdrawal between 15 days - 30 days of program materials being mailed, and all materials returned in original condition: 75% refund of tuition.
· Request for withdrawal between 31 days - 45 days of program materials being mailed, and all materials returned in original condition: 60% refund of tuition.
· Request for withdrawal between 46 days - 60 days of program materials being mailed, and all materials returned in original condition: 40% refund of tuition.
· After 61 days: no refund
· If materials are not returned in original condition within 14 days of withdrawal request $100.00 will be deducted from the amount to be refunded.
Note: future tuition payments are non-refundable once the student has been enrolled in the module.
Enrollment Deadlines
Applications must be postmarked no later than December 1st in order to begin the January class and attend the April Introduction to Midwifery Workshop, or June 10th in order to begin the July class and attend the November workshop. Letters of recommendation must be received in the ATMMTP office no later than 5 days following an enrollment deadline. Note that class size is limited to 20 students. If the current class is fully you will be contacted and options explained. Both application fee and tuition will be refundable.
432-664-8845 Application for Enrollment EA-2016-3 Page 11 of 21
Table of Contents
Association of Texas Midwives
Midwifery Training Program
P.O. Box 887 Elmendorf TX 78112
Applicant’s Name:
You will need everything on the following checklist:
Application Checklist
☐ Completed application form (sections 1-4)
☐ Signed Financial Agreement
☐ A legible photocopy of your driver’s license. You must have a car and driver’s license in order to complete clinical training.
☐ Proof of at least a high school education or equivalent. You must have either high school or home school transcripts, or a GED certificate with exam scores. A copy of a diploma is not adequate for enrollment. A college transcript will be accepted in lieu the above.
☐ At least one of the following
☐ SAT scores within the previous 10 years
§ Test prior to 3/1/16, minimum score of 1500
§ Test on/after 3/1/16, minimum score of 1000 (essay is not required)
☐ ACT scores within the previous 10 years, with a composite score of at least 18 and a score of at least 18 on the writing test, or a composite score of 18 on English Language Arts in lieu of a score of 18 on the writing test
☐ Completion of college core curriculum courses with a GPA 2.0 or better. (May be submitted as proof of high school)
☐ A college degree (transcripts required) (may be submitted as proof of high school)
☐ Proof of current healthcare provider CPR. Include a photocopy of both front and back of card. Certification must be one of the following:
☐ American Heart Association: Basic Life Support for the Healthcare Provider
☐ Red Cross: Basic Life Support for Health Care and Professional Rescuers
☐ National Safety Council: Basic Life Support for Health Care and Professional Rescuers
☐ Signed copy of the “Permission to Release Test Scores”
☐ A signed copy of the “Readiness-Commitment Survey”
☐ A copy of applicant’s Association of Texas Midwives Membership Application.
☐ A copy of this checklist
You will also need:
☐ Two letters of recommendation. Recommendations must be on the provided forms and mailed by the referrer to the ATMMTP office. (See section 5 of application.)
Payment of all of the following must be included with application or be paid via Pay Pal from the ATM website (include copy of receipt):
☐ Tuition payment for first module: $ 995.00
☐ Application Fee ($150.00, for U.S. students, $200.00 for students in Mexico or Canada)
☐ Student membership if not paid on-line: $ 30.00 annually or prorate at $ 2.50 per month. All memberships expire on December 31st of each year.
You may send one check for all fees due.
432-664-8845 Application for Enrollment EA-2016-3 Page 11 of 21
Table of Contents
Association of Texas Midwives
Midwifery Training Program
P.O. Box 887 Elmendorf TX 78112
Application for Enrollment
Please read instructions carefully prior to filling out this application. Incomplete applications will not be accepted.
Section 1: Personal and Demographic Data
Full legal name: / Date:Maiden name: / Other names used:
Address:
City: / State: / Zip:
E-mail address:
Phone:
Cell: / Home: / Driver’s License #: / State:
Date of birth: / Age: / Date of first planned workshop: April Nov
ATM membership: I am already a member of ATM I have included ATM membership
Section 2: Background Information
1. Complete the following, as applicable:☐ High school ☐ Home school ☐ GED Year graduated:
☐ SAT: Year Composite score:
☐ ACT: Year Composite Score: Writing Skills Score:
☐ College (all core courses completed): Year: Hours: GPA:
☐ Degree: Year completed:
2. Do you have training/certification/licensure in any of the following? For each item checked indicate if you graduated or received certification, or if you did not complete the course:
Doula Childbirth Education
LVN/LPN RN EMT/Paramedic