Undergraduate Student Application

First Name*

Last Name*

Preferred Name

What are your pronouns? (For example: she/her/hers, they/them/their, he/him/his, etc. This information will be used to uphold our institutional commitments to gender inclusivity and respectful communication during the admissions process. You can also write "Prefer not to answer.")*

Please list all of your prior names.

Please select your requested degree.*

What semester are you applying for (i.e., first semester of enrollment/taking classes)? *

Street Address*

City*

State/Province*

Postal Code*

Country*

Phone Number*

Alternate Phone Number

Email Address*

Full Date of Birth (including your birth YEAR) YYYY-MM-DD*

Birth Place: City, State/Province, Country*

Have you participated in a required, online MCU Admissions Open House? *

Within 1 week of submitting my application, I agree to access https://www.midwifery.edu/application-process/admissions-open-house/ to participate in the recorded, required, online MCU Admissions Open House.*

Do you expect to practice in Washington, California, or Canada at any point during your education or while practicing as a midwife in your future career? Check all that apply. (Additional licensure/program requirements will apply.)*

Are you a first generation college student (defined as a student who is degree seeking when a parent and/or grandparent has not graduated with a college diploma)? ***If you have previously earned a college degree and were a first generation college student, please select YES. *

I understand that Midwives College of Utah is a direct-entry midwifery program that prepares students to become Certified Professional Midwives and/or licensed midwives to primarily practice in community based settings (home births, birth centers, midwife offices, and clinics). *

I understand that Midwives College of Utah does not have a program for those who want to become Certified Nurse-Midwives or for those who want to practice in hospitals or physician's offices. *

By checking this box, I consent to do business electronically with Midwives College of Utah. I understand that student business will be conducted electronically such as (but not limited to) admissions, enrollment/matriculation, registration, Form 1098-T, collection notices, invoices, financial aid correspondence, general correspondence, assignment submission, feedback and grading.*

Do you already have an MCU User account from a prior application, previous enrollment, or previous registration for Continuing Education courses? (NOTE: If you previously had an MCU username, but have FORGOTTEN it, please email admissions@midwifery.edu for your username - DO NOT MAKE A NEW ACCOUNT.)*

Choose a Username*

Choose a Password*

Confirm Password*

Existing Username*

Existing Password*

When did you submit your previous application?*

Have you previously been enrolled in an MCU program (other than continuing education courses)?*

Which program were you enrolled in?*

Did you complete the program?*

Please provide reason for withdrawal.*

Date of withdrawal.*

Have you ever enrolled in Continuing Education courses at MCU? (To learn more about MCU's Continuing Education courses, please access this webpage: https://www.midwifery.edu/continuing-education-and-ceus/)*

How did you learn about Midwives College of Utah? (please check all that apply)*

What is the primary reason you are seeking enrollment at Midwives College of Utah? Choose ONE option.*

Please select any other secondary reasons you have for seeking enrollment at MCU. Choose ALL that apply.*

Is English a primary language that you spoke in the home from the time you learned to speak through childhood?*

Is your TOEFL score 88 or higher? (TOEFL: Test of English as a Foreign Language) Please send TOEFL documentation in PDF format to admissions@midwifery.edu. *

Do you speak any languages besides English?*

Please indicate which other language(s) you speak.

What are your religious or spiritual affiliations (optional)?

What is your Armed Forces status?*

Please indicate your residency status. (The US Department of Education mandates educational organizations collect this information.)*

Ethnicity - Do you identify as Latinx/Hispanic/Spanish of any race? (The US Department of Education federally mandates educational organizations to collect this information using these categories.)

Latinx/Hispanic/Spanish

Race - please check all that apply. (The US Department of Education federally mandates educational organizations to collect this information using these categories.)

Tribal Affiliation

Please identify any learning difficulties and/or medical conditions you wish to disclose that may impact your educational experience or require accommodations. (Any information disclosed will not impact admissions decisions; it will be used to aid newly accepted students to access needed or desired support services.)

Have you ever been declared mentally incompetent in a legal proceeding?*

Do you have any pending criminal charges against you, or have you ever been convicted of a felony or misdemeanor other than traffic violations in federal, state, local, military, tribal court or another country?*

Please explain criminal charges or felony/misdemeanors.*

Has any government or regulatory agency ever found that you committed child abuse or neglect, elder abuse or neglect, or misappropriated (improperly took or used) the property of a person or client?*

Please explain abuse/neglect.*

Are you planning to apply for Federal Financial Aid? (Note: MCU's school code for the FAFSA is: 042183.)*

Have you completed your FAFSA and identified MCU as a school you hope to attend? (If you have not done so, please complete your FAFSA ASAP - do not wait until you receive an admissions decision to do so.)*

Are you planning to use VA, Voc Rehab, and/or any type of military related funding at any point for your midwifery education? If you are not certain yet, but it is a possibility that you may use this type of funding, please choose YES. *

Are you planning to reside outside of the United States for any length of time while you are enrolled in academic courses and/or clinical courses? (If YES, you will need to complete an additional International application process and pay an additional International application fee.) *

Please provide the contact information for two references and upload the corresponding two letters of recommendation in PDF file format. These letters must be provided by two independent individuals who are unrelated to you and can identify your aptitude for rigorous academic study combined with the unique challenges associated with birth work. If you have identified that you have experience attending births, ideally one reference should be from someone who has observed you in a birth setting. Please upload documents only in PDF format.

I waive the right to have access to letters/communication from and with the listed Recommenders. (Note:The Family Educational Rights and Privacy Act (FERPA) confers admitted students certain rights, such as access to inspect their educational records. Because FERPA gives students these rights, MCU cannot require you to waive these rights.)*

Name of Recommender 1*

Email Address for Recommender 1*

Phone Number for Recommender 1*

Letter of Recommendation 1 - PDF Format*

Name of Recommender 2*

Email Address for Recommender 2*

Phone Number for Recommender 2*

Letter of Recommendation 2 - PDF Format*

Please upload your High School Diploma/Transcript or GED documentation or Homeschool Transcript. (REQUIRED of all applicants who have not completed a bachelor's or graduate degree at an accredited academic institution.) *

Have you previously enrolled at any post-secondary institutions? (This includes certificate or training programs, trade programs, community colleges, colleges, and universities. You MUST identify ALL previous institutions even if you feel transfer credit will not apply from credits earned.)*

MCU uses a holistic admissions process to seek to get to know the "whole person" in our admissions process. We recognize that our applicants may have experienced previous challenges with college-level academics. If you have had those struggles, we would like to learn from you about how you grew as a person and student through those academic challenges. In your past academic experiences (after high school/GED), have you struggled with maintaining your grades, had a GPA equal to or below 2.0 for one or more semesters, and/or had more than a few withdrawals from courses?*

Briefly tell us what lessons you learned from your previous academic struggles that you will use to inform your plan for student success in your academic courses at MCU? (600 characters or fewer - not words.)*

Have you earned a Bachelor’s or graduate degree at an accredited post-secondary institution (community college, college, university)? Please select your answer CAREFULLY. It is considered a form of academic dishonesty if you select “Yes” if you have not earned a Bachelor’s or graduate degree.*

Important notes for applicants who have previously earned ANY credits at any post-secondary institutions:

• MCU requires you to submit unofficial or official transcripts for ALL post-secondary coursework that was completed for credit, even if you feel transfer credit will not apply.
• All transcripts must be received within three (3) weeks following the application deadline.
• If you do not want your transcripts reviewed for transfer credit evaluation, you may submit PDF format files of UNofficial transcripts to admissions@midwifery.edu. If you would like your transcripts evaluated for transfer credit, you must request official copies of your transcripts be submitted directly from the institution you attended to MCU.
• If you are currently taking coursework that is in progress at another institution, you must submit a final transcript after your grades have been posted for the semester.

In the section below, please list ALL post-secondary institutions that you have attended in your lifetime and submit unofficial transcripts to admissions@midwifery.edu for each institution (or official transcripts if seeking transfer credit). Please reference the important notes above.

Institution 1

Years Attended 1

Degree 1

Institution 2

Years Attended 2

Degree 2

Institution 3

Years Attended 3

Degree 3

Institution 4

Years Attended 4

Degree 4

Institution 5

Years Attended 5

Degree 5

I have submitted my unofficial transcripts in PDF format to admissions@midwifery.edu AND/OR I have requested my official transcripts from all post-secondary institutions (including certificate or training programs, community colleges, colleges, and universities) to be emailed directly to admissions@midwifery.edu OR mailed directly to Midwives College of Utah, 1174 E. Graystone Way, Suite 2, Salt Lake City, UT 84106.*

The following training/experience/certifications are not required to be offered admission to MCU; however, they may strengthen your application and will enhance your preparation for pursuing midwifery education.

Birth Doula: Please check all that apply. *

Proof of Birth Doula Training (PDF file format)*

Proof of Birth Doula Certification (PDF file format)*

Other Relevant Experience/Training/Certification. Please check all that apply. (For any training or certificate programs, you may be asked to provide supporting documentation.)*

If you are a currently practicing midwife applying for the CPM-to-BSM program, please upload the required proof of CPM, LM and/or CNM status, if applicable (PDF file format).

Proof of Current NRP Certification, if applicable (PDF file format)

Proof of Current CPR Certification, if applicable (PDF file format)

Additional Relevant Certifications or Trainings

Description

File (PDF file format)

Description

File (PDF file format)

The following experience is not required to be offered admission to MCU; however, this type of experience can strengthen your application and will enhance your preparation for pursuing midwifery education.

Have you had experience with working or serving in an "on-call" capacity? (Please check all that apply.)*

How many births have you attended in any capacity? *

Please describe the capacity you were serving in the births you attended. (Check all that apply)*

Have you identified possible clinical placements in your area?*

Are you currently working with a preceptor in your area? PLEASE NOTE: MCU does not require or recommend having a preceptor in place prior to beginning your academic studies. We encourage you to make connections within the midwifery community. However, there are numerous benefits to waiting to develop a formal clinical commitment until after the first several months to a year into the program. If you are already working with a preceptor in any capacity (assistant, PEP student, student), please answer yes to this question. Thank you.*

Please identify the preceptor name(s).*

If preceptors are not available in your area, how far are you willing to travel and/or relocate in order to fulfill your clinical placement requirements?*

Do you have or will you have a driver's license and access to reliable transportation once you are attending births?*

Do you intend to apply for life experience credit? PLEASE NOTE: The MCU Portfolio Evaluation Process application must be submitted following notification that you have been accepted for admission. For more information regarding life experience credit, please visit our FAQ page located on www.midwifery.edu.*

Do you have experience with a distance learning education class or program? *

Do you have access at home to a computer and high speed Internet?*

Please identify how/when you will have access a computer and the Internet.*

Do you have experience using the following? (Check all that apply.)*

We value strong writing skills and creativity at MCU. Please answer the following questions in a short essay format. Maximum character limits will apply. Feel free to use your own writing software to ensure that you send us your best effort. Please note that free editing software is available at www.grammarly.com to assist you with grammar, structure, and spelling.

Why are you passionate about midwifery and how has this led you to apply to MCU? (1400 or fewer characters maximum - not words) *

Please share your vision of your midwifery career. Who will you serve as a midwife and in what setting(s)? How will you contribute to the broader midwifery community? (1100 characters maximum - not words.)*

Describe the legal status and scope of practice of Certified Professional Midwives in the United States and in the state(s)/geographic area you plan to practice midwifery. (1100 or fewer characters maximum - not words.)*

What are the challenges and/or obstacles you will face to completing your midwifery education while balancing the significant demands of an on-call midwifery lifestyle that is typically required for student midwives? Discuss your plans for meeting these challenges and fitting your academics/clinical responsibilities into your life. (1200 characters maximum - not words). *

Distance education requires that students are motivated and self-directed. Please describe a situation in which you demonstrated self-direction and personal motivation. (850 characters maximum or fewer - not words.)*

Tell us about your characteristics that allow you to learn/work respectfully with fellow students and pregnant/birthing people/families whose belief systems, health choices, identities, and family structures are different than your own. (1000 characters or fewer - not words.)*

MCU is a committed ally to all underrepresented individuals/families who seek access to midwifery care and those who strive to become midwifery providers within their communities. In your region, please identify who has not traditionally had access to community-based midwifery care and please share your goals (if any) for serving this population. If you are a part of an underrepresented community/population that has not traditionally had access to community-based midwifery care, please share how you will meet the unique needs of your community/population. (1000 characters maximum or fewer - not words.)*

IMPORTANT! ADDITIONAL ACTION REQUIRED - PLEASE READ: Clicking the button below "Submit to MCU" is NOT your final step. In order to submit your application for review for admission to MCU, you must complete these last few steps that should only take a few more minutes:

• You MUST open the automatic email you will receive after clicking "Submit to MCU" and follow the final steps listed there.
• Login to your midwifery.edu account (login link is on the top left above the "Home" button on midwifery.edu).
• Pay your application fee.
• Upload a JPG headshot-style photo (which will be used for printed student IDs).
• Electronically sign/submit your final application.
  By checking this box, you are agreeing to complete these final steps to submit your application for review. You're almost done and we look forward to reviewing your application!*