New Grad Midwife Funding Application Form

New Grad Midwife Funding Application Form

For those planning to work as an LMC in Te Awa Kairangi/the Hutt Birthing Community

Members of the Oxytocin Trust Board will review this application and make a decision according to alignment with our Trust purpose, priorities and funds available. The simple criteria for a new graduate midwife is:

(a) A show of commitment to work as an LMC within the Hutt Community supporting those who are birthing and becoming new parents for a minimum of 6 months

(b) Applicant (individual or group) is not receiving funding from any other source for the same purpose or activity

(c) A commitment to send a follow-up to the Oxytocin Trust (as a written statement or an audio, or a video) to give details of how the grant supported you and, with your permission, for us to share that information to encourage future donations to the fund

The deadline for applications being received is Friday 20th December 2024. Your application will be processed within 4 weeks of this date, provided you have received your exam results by then, and you will be contacted with the outcome. We may be in touch sooner if we require further information. If your application is approved, the funding will be provided as soon as possible.

About you

Your email address *

Your name *

First name

Last name

Your phone number *

Your address

Address line 1

Address line 2

Address line 3

Address line 4

Town/Suburb

City

Postcode/Zip

Tell us a bit about yourself

We would love to know a little about who you are and your mahi in Te Awa Kairangi/the Hutt Community. If you are a new grad applying for funding to start work in our community, tell us about your studies (eg. where they were, how long were they, when did you graduate etc...)

Exam date (if known)

Will you be working for a particular midwifery group when you start practice? *

If yes to the above question, what is the name of the midwifery group?

When will you start work in Te Awa Kairangi/Hutt Valley birthing community? *

Registration Number and student number etc...

If you don't already have your registration number (APC#) with Midwifery Council please do forward it to us later.

About the funding you are requesting

Total Costs Associated with Funding of this Activity? *

You can email us with more detailed breakdown to oxytocintrust@gmail.com, or we may request more info when reviewing your application

Have you applied for/will you apply for funding for this same purpose/activity from another source? *

If you answered "yes" above, please indicate how much you have/will apply for and where from

Your bank account name *

Your bank account number *

Please double, nay triple check this account number

Anything else you would like to say in support of your application?

Your agreement

I agree that, to the best of my knowledge, the information I have provided here is honest, correct and accurately reflects my current position *

Please re-read the application criteria below and confirm your eligibility and agreement with these statements by ticking the box *

The simple criteria for a new graduate midwife is:

(a) A show of commitment to work as an LMC within the Hutt Community supporting those who are birthing and becoming new parents for a minimum of 6 months

(b) Applicant (individual or group) is not receiving funding from any other source for the same purpose or activity

(c) A commitment to send a follow-up to the Oxytocin Trust (as a written statement or an audio, or a video) to give details of how the grant supported you and, with your permission, for us to share that information to encourage future donations to the fund

NB. Please upload any supporting documentation that will show your new grad status and the expenses you may have already paid, or will need to pay e.g. receipts/paid invoices or quotes

e.g. exam result confirmation doc, receipts/proof of payments for midwifery registration etc. Alternatively you can email your supporting documentation through to oxytocintrust@gmail.com

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By completing and submitting this application, you give us permission to add you to our online database. Our database allows us to communicate with you more effectively and display your details in our directory so that other people working in Te Awa Kairangi/the Hutt Valley perinatal space can find you

A photo of you would be really helpful as it enables us and those searching the directory to get to know who you are

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