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Friend/Supporter of NEDA
Annual Membership Fee
*
$25
Your credit card will be renewed automatically on your sign-up date to ensure your membership for the next year.
Yearly
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Email
*
Verify Email
*
Phone
*
Website, beginning with http://www.
Gender
*
select one
Female
Male
Transgender
Non Binary
Gender Variant/Non-Conforming
Other
Prefer Not to Answer
Age Range
*
select one
18 - 25
26 - 35
36 - 50
51 - 60
60+
Race / Ethnicity
*
Check all that apply
Caucasian
African American /Black
Latinx
Native American
Asian
Bi-Racial
Multi-Racial
Other
Prefer not to answer
Education Level
*
select one
Did not graduate from high school
High school graduate or GED
Some college
College degree
Graduate school
Professional degree
Current Occupation
*
I am joining NEDA because:
*
Please check all that apply
I am an aspiring EOLD
I have worked in a profession closely associated with EOLD and want to see it grow
I have benefited from doula services in the past
NEDA Friend / Supporter Directory
*
I acknowledge that by agreeing to have my contact information listed on the NEDA Online Directory I may be contacted by individuals, companies, or groups not associated with NEDA. My contact information will be public and cannot be controlled by NEDA.
Yes, I want to be included in the website Directory
No, I do not want to be included in the website Directory
Permission to be Added to NEDA Email List
*
NEDA sends out a monthly newsletter. You always have the option to unsubscribe to the emails at any time.
Yes, I want to receive the monthly newsletters
No, I do not want to receive the monthly newsletters
Directory Agreement
*
By clicking the box below, I am indicating that I understand and accept the following terms: 1) Inclusion of my information on the website directory does not constitute endorsement by NEDA or my training organization, if I have one. 2) I am fully responsible for my own contracts, promotion, and interaction with the public. 3) I have read and agree to honor the NEDA Code of Ethics, Conduct, and Scope of Practice. 4) I understand that my listing on the website directory will only be included as long as I am an active member of NEDA (renew each year).
Yes, I agree
Add 3% to my total amount to help cover the payment processing fees
