Application for Enrollment in
Advanced Midwifery Studies

We are excited that you've chosen to pursue a career in midwifery, and that you've chosen Ancient Art Midwifery Institute for your education. The form that follows is your online Application for Enrollment. It is for serious applicants only, and payment is expected once you hit the "Submit" button.

If you are uncertain about enrollment, please do not fill out this form. Browse our web site...everything we send out in a pre-enrollment packet is here. Then, if you still have unanswered questions, feel free to email us at info@ancientartmidwifery.com

Check on Current Enrollment Discounts

IMPORTANT!!!!

If you wish to pay by check you must PRINT THE APPLICATION FORM AND MAIL IT!!!!!!!! Do NOT enroll online unless you are ready to provide PAYMENT IN FULL via PayPal or by phone. We can accept Discover, American Express, MasterCard and Visa over the phone. Call Carla at 918-720-2717 if you prefer to pay for your enrollment this way.

All Fields Are Required
Full Name:
format: first mi last, title
Email:
Shipping Address:
Mailing Address:
City:
State:
Zip/Postal Code:
Phone:
Country:
Present Occupation:
Age:
Marital Status: Single Married
Ages of Children:

Average number of hours you plan to commit to the course each week
How long have you been studying midwifery on your own?
What birth related magazines or journals do you regularly read?
Will you have difficulty buying and/or borrowing a large number of books?
Approximate # of birth related books you have read:
Approximate # of birth related books you have access to:

Do you consider yourself, as a student: below average
average
above average
excellent
Graduate of:      
High School
Year:
Home School Year:
GED Year:
Vocational/Technical School Year:
College Degree:
Currently Attending College
Currently Homeschooling
Nurse
Nursing Student
at
Planning to eventually become a CNM
Childbirth Educator Certified with?

If you are not currently practicing or apprenticing, do you forsee any difficulty
in securing an apprenticeship?
Yes No
If yes, please explain.
Approximate number of practicing midwives in your state?
Local area? Do you know them?
Is midwifery legal in your state? Explain:
Licensing requirements, if any:
Number of Pro Home Birth Doctors in your area:
Number of Pro Home Birth Childbirth Educators in your area:
Are you a part of your state midwifery organization? Yes No
Courses you plan to take concurrently with this one:
Do you know other enrollees? No Yes Whom?



ENROLLMENT AGREEMENT

I understand and agree to the following:

Ancient Art Midwifery Institute reserves the right to accept or reject any applicant. A telephone interview may be required.

No refunds are given for any reason and all payments are due, regardless of the length of enrollment.

An Annual Report and Annual Report Fees of $25 is required yearly to maintain active status. A US $75 rebate will be awarded upon graduation to students who are never late with Annual Reports or Annual Report Fees. This rebate is available only to those enrollees in good standing. Enrollment may be terminated, without refund, if I fail to submit Annual Reports (2 probation notices precede termination).

All initial deposits or payments in full that are not wire transferred must be made in the form of Cashier's Check, Money Order, or PayPal (US funds only).

A US $250 deposit (in addition to tuition) is required upon request of the Study Guide. The Study Guide will not be sent until this deposit has been received by AAMI. The Study Guide remains the property of Ancient Art Midwifery Institute and must be returned upon the termination of enrollment for any reason. The US $250 deposit, plus and additional US $25, will be returned to the student when the study guide is returned. Students who withdraw on their PCD (projected completion date) without having graduated, are not eligible for the additional US $25. Students who withdraw prior to their PCD or who have not met all financial obligations to AAMI are not eligible for any refund of the curriculum return deposit. Should I fail to return the study guide upon completion, expiration, or temination of the program, I agree to forfeit my desposit of US $250.

Initial enrollment is 39 months. Extensions are granted at the discretion of the director and there are no Leaves of Absence granted.

Ancient Art Midwifery Institute reserves the right to accept or reject any submitted work. Submissions will be returned, at the student's expense, if grossly incorrect, undocumented, unbound, or the student's file number is not on every page.

All AAMI material is copyrighted. It is illegal and unethical to copy or share or sell course materials (it is necessary for students to copy certain course forms and clear instructions are provided that indicate which forms this exception pertains to). The Study Guide remains the property of Ancient Art Midwifery Institute and must be returned upon the termination of my enrollment for any reason. I will forfeit my US $250 deposit if it is not returned within one week after termination.

A collection agency will pursue all legal avenues of collection of any fees not paid. Any checks that do not clear and are not collectable will be turned over to law enforcement agencies. There is a US $50 fee for EVERY returned check or declined charge. After a third incident, payment of the entire balance is due in full within 10 days.

There is a US$250 testing fee to cover the cost of the required final exams. Fee is waived if student submits course assignment within the first year.

If you are unable to make payment in full, we offer 0% interest payment options. A special payment agreement is required, with Social Security number and a telephone interview with the director before any payment plan can be approved. Balance is paid in equal monthly payments over no more than 24 months. Keep in mind that ALL payments are due regardless of length of enrollment. Do not sign an agreement you do not fully intend to honor. An additional charge of US $50 will be imposed per returned check AND all uncollectible checks will be turned over to local check collection authorities and/or independent collection agencies. We can only continue to offer payment plans as long as enrollees honor their word so we are very serious about this issue. We do not make credit checks, but AAMI reserves the right to reject any applicant of the Payment Program if we determine that there is not sufficient intent to honor the agreement. For Payment Program details and/or payment program code, contact Carla at 918-720-2717 or carla@ancientartmidwifery.com.

We no longer charge an additional mailing fee for Canadians but residents outside of North America pay a one time fee of $50 for additional mailing costs.

Add $30 for a PDF format ebook version of Helping Hands, The Apprentice Workbook if you do not already own it.

Every requirement must be completed and the US$250 exam fee must be paid before a student becomes eligible for the Certification Exam. In addition, a score of 70% or higher on the MSAT must be achieved. Graduates receive either a Certificate of Successful Completion, an Award of Academic Achievement or an Award of Academic Excellence, determined by the quality of work submitted.

All work submitted must be completed by the student only and may not be the copy of another student's work.

In addition to the stipulations above:

I realize that there will be expenses other than tuition and the above mentioned fees and deposits. This includes, but is not limited to, books, photocopying, postage, conference tapes and supplies.

I understand that this course is intended as preparation for, or complement to, practical experience under a supervising midwife. AAMI may be able to provide assistance in locating a preceptor but cannot make that guarantee.

I understand that this course demands a great deal of time and study. What I learn depends on how much effort I invest.

I will not, under any circumstance, misrepresent myself as a qualified birth attendant based on enrollment in, or completion of, this course alone. I am in complete agreement that my education will not be complete without an apprenticeship and other forms of practical experience.

I will not represent myself as a graduate until I have the certificate in my possession.

SUBMISSION OF THIS FORM IS EQUIVALENT TO SIGNING THIS DOCUMENT AND SHALL BE CONSIDERED LEGALLY BINDING. PLEASE PRINT A COPY OF THIS COMPLETED FORM FOR YOUR RECORDS.

I have read the entire AAMI website and understand and agree to the stipulations of enrollment in Advanced Midwifery Studies. I have made the decision to enroll fully aware that the course is comprehensive and therefore time consuming, that books are not provided with tuition, and that there will be no tuition refunds for any reason. Once I have been approved and assigned a file number, there will be no refunds or exchanges. The course materials remain the property of AAMI and may not be shared, copied or sold for any reason. If approved, enrollment benefits commence immediately with the first instructions and proprietary information via email. Initialing this space constitutes legal signature.

Please type your initials in this box to indicate that you've read and understood the agreement. Initialling this space constitutes legal signature.
I have read and understand the Enrollment Agreement and agree to the terms and conditions presented herein.
Initials:
Name:
Age:
Today's Date:

Please double-check all your answers and be certain that you've filled in each field. When you're ready, click the "Submit Application" button below. Afterward, you'll see a page verifying what was sent, which you should print for your records. Once your application has been accepted, you may add options later such as the Philomath Program, Childbirth Educator Certification, Preceptor Verification Program (documents apprenticeship), extensions and other options. Click on the link provided there to choose your Course Options and Payment Plan, and make your first payment on our secure server. We accept credit cards via PayPal ONLY (you may use a credit card that you have on file with PayPal, but we at AAMI do not process credit cards). We also accept wire transfer and personal checks.

Cancellation Policy: Cancellation is possible only in the first 72 hours after either payment or enrollment form is received. Cancellation must be in writing and dated. We do not process enrollments until the 72 hour limit has passed.


Carla Hartley
Founder, Director

IMPORTANT!!!!

If you wish to pay by check(s) you must now PRINT THE APPLICATION FORM AND MAIL IT to AAMI, PO Box 69, Foyil, OK 74031.
Do NOT enroll online -- DO NOT CLICK THE BUTTON BELOW -- unless you are ready to provide PAYMENT IN FULL using PayPal. Regular tuition is $3950. See Tuition page.