Join or Update your PNSW profile

To be listed on this register you must have graduated from the Perinatal Support Worker Program or be registered in the practicum. In order to be added or to update your profile, please use the form below.

It is important you keep watch of your page to ensure all documents are updated so you remain in "Active Status".

YOU MUST SUBMIT ALL DOCUMENTS IF YOU ARE JUST ENTERING YOUR PRACTICUM!!!!

OTHERWISE ONLY SEND DOCUMENTS THAT ARE MISSING FROM YOU PROFILE.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Please select the closest statement *

I have completed my in class PNSW program and working on my practicum. I have graduated from the PNSW program.

What year did you start your practicum or graduate from the program? *

Upload your Back check / Police check *

Max file size: 20MB

Upload your insurance (Insurance must indicate Perinatal Support Worker on it) *

Max file size: 20MB

Upload your CPR *

Max file size: 20MB

Practicum only: Upload your proof of pre-placement course registration at Mohawk College *

Max file size: 20MB

Upload a recent headshot (this is to protect your identity) *

Max file size: 20MB

Comments or questions *

I understand that filing this request does not guarantee my acceptance onto the registry. Once your submission has been reviewed, someone from our team will be in touch via email. *

I understand

Submit

YOU MUST SUBMIT ALL DOCUMENTS IF YOU ARE JUST ENTERING YOUR PRACTICUM!!!!OTHERWISE ONLY SEND DOCUMENTS THAT ARE MISSING FROM YOU PROFILE.

YOU MUST SUBMIT ALL DOCUMENTS IF YOU ARE JUST ENTERING YOUR PRACTICUM!!!!

OTHERWISE ONLY SEND DOCUMENTS THAT ARE MISSING FROM YOU PROFILE.