Letter of Intent

To apply, you must pay the $100 application fee, complete and send the CMM a Letter of Intent and Verification Documents.

Your Letter of Intent must follow this template letter exactly. A printable Letter of Intent is also available.

  • The next application deadline is September 6, 2017.
  • Letters of Intent received via email will be accepted.  Please email to admin@midwives.mb.ca
  • You must also submit your Verification Documents and your $100 application fee by September 6, 2017.  Fees are payable by certified cheque, money order or cash.  Do not mail cash.

LETTER OF INTENT

I, ______________________________ (print first and last name) am applying to participate in the Assessment and Gap Training process as an internationally educated midwife (IEM).

Midwifery Education:

1. Name and location of my university, college, school or institution:

______________________________(name of school)  , _____________________   (city)     , ______________________ (country).

2. Length of my midwifery education program: _________ (years) and date of graduation ______________ (mm/yy).

Clinical Experience:

3. Total Number of births I attended as primary midwife (most responsible attendant): ______________.

(Births attended as primary midwife under supervision as part of a midwifery education program may be included. Transfers of care may be included if the applicant managed care in labour to point of transfer.)

4. Length of time I practiced (worked) as a midwife: _________ (months/ years).

5. Location and date that I last practiced as a midwife:

_____________________________ (City, Country) , ________________________  (month/year).

Language:

6. The language in which I am most comfortable communication is _________________ (language).

7. My midwifery education program was in __________________ (language).

Residency:

8. I am a (please check one):

Ο Canadian citizen          Ο Permanent resident            Ο Other (provide explanation)

9. I have lived in Manitoba since ______________ (date).

I understand that making any false or misleading statements in this Application and Letter of Intent may disqualify me from the IEM Assessment and Gap Training Process.

Signature: __________________________________             Date: ___________________

Email Address: (please print clearly)______________________________

Phone number: ___________

Mailing Address: _________________________________________________________