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.
- Submit your letter of intent and all supporting materials by the application deadline.
- Letters of Intent received via email will be accepted. Please email to firstname.lastname@example.org
- You must also submit your Verification Documents and your $100 application fee by the application deadline. Fees are payable by cheque, money order or credit card. When paying by credit card the CMM charges a 2.45% credit card fee. 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).
- Name and location of my university, college, school or institution:
______________________________(name of school) , _____________________ (city) , ______________________ (country).
- Length of my midwifery education program: _________ (years) and date of graduation ______________ (mm/yy).
- 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.)
- Length of time I practiced (worked) as a midwife: _________ (months/ years).
- Location and date that I last practiced as a midwife:
_____________________________ (City, Country) , ________________________ (month/year).
- The language in which I am most comfortable communication is _________________ (language).
- My midwifery education program was in __________________ (language).
- I am a (please check one):
Ο Canadian citizen Ο Permanent resident Ο Other (provide explanation)
- 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: _________________________________________________________