NWL Breastfeeding Support for All Minority Communities: Mother supporter application

We are gathering this information for the purpose of selecting people to receive funding to carry out the Association of Breastfeeding Mothers' "Mother Supporter" training course. The information will be stored securely via Survey Monkey and in a password protected spreadsheet and will only be stored until the selection process is complete, at which point the information about anyone not selected will be deleted. 

Information on the selected candidates will be stored until after their training is complete for follow up purposes, and after that time only names and contact emails will be stored to maintain contact with funded supporters. 

By completing this form you consent to your information being used in this way, and to NWL BSAMC contacting you. If you have any questions please contact NWLBreastfeeding@gmail.com

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* 1. Full name including surname

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* 2. Name on Facebook if different to Q1

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* 3. Email address

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* 5. Have you breastfed, combination fed or pumped for at least 6 months?

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* 6. Do you come from a minority community which you feel would particularly benefit from your training? Please give details.

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* 7. Please tell us in a couple of sentences why you would like to train as an ABM mother supporter

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* 8. Please tell us in a couple of sentences how you plan to use the training.

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* 9. Please tell us in a couple of sentences why we should choose you.

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