UBC Midwifery Supplemental Application

INFORMATION REQUIRED ON THE SUPPLEMENTAL APPLICATION

DO NOT COMPLETE AND SUBMIT THIS FORM. THIS IS PROVIED AS INFORMATION ONLY TO
HELP YOU PREPARE. ALL INFORMATION MUST BE ENTERED ONLINE DURING THE
APPLICATION PROCESS TO UBC AND THE MIDWIFERY PROGRAM.
APPLICATION FOR ADMISSION:
Intake Year:

Applicant Number:

Country of Birth

BC Resident / Current Rural BC Resident

First Language

Other Language(s)

RESUME FOR ADMISSION

Education Details
Experiences can only be listed once. If they fall into more than one category, choose the one you think
most suitable.
1.

Have you completed a University Degree?

If Yes, in what field of study:

Yes

No

2.
3. If No, how many credits have you earned towards a degree?
4. Do you have a Graduate Degree?
If Yes, in what field of study:
5.

Yes

No

If your education has not been continuous, please provide details of your activities in recent
years.

Education History (High School, College, University, Other include degrees)

Institution

Diplomas, Degrees, Certificates, #

of Credits Earned

Awards and Scholarships

Institution

Course in
Progress

Type of Employment

Volunteer Experience (last 5 years)

Organization
Positions Held or Activities

To
mm/yyyy

yyyy

Description

Research and Publications (if applicable)

Funding agency or Publisher
Title:
Employment History
Employer

From
mm/yyyy

yyyy

From: mm/yyyy

To: mm/yyyy

From: mm/yyyy

To: mm/yyyy

Technical Skills (e.g. First Aid, CPR, Computer Skills, Public Speaking
Skill or Certificate Held

yyyy

Leadership/Experience working with others (last 3 years)

Type of Experience

To: mm/yyyy

From: mm/yyyy

Accomplishments And Activities About Which The Committee Should Be Aware (Academic, Arts
Athletics, Etc.)
Activity

PERSONAL STATEMENT
Compose a concise, well organized essay that encompasses information relative to the questions listed
below, in the order listed.
The essay must be between 3,000 and 4,500 characters. This is comparable to 1 to 2 pages that are
single spaced using a 12 point font, with an extra line between paragraphs. The character includes
spaces, tabs, and lines between paragraphs.
Introduce yourself to the committee and answer the following statements:
Describe the development of your interest in a career in midwifery. Why have you chosen this
degree rather than a degree in another field?

Provide information on life experiences, cross-cultural interactions, areas of expertise, or

knowledge, which may contribute to your achievements and success in midwifery education,
research, or practice
Describe your short term and long term professional goals.

DO NOT COMPLETE THIS FORM. THIS IS PROVIDED AS INFORMATION ONLY TO HELP YOU
PREPARE. ALL INFORMATION MUST BE ENTERED ONLINE DURING THE APPLICATION
PROCESS TO UBC AND THE MIDWIFERY PROGRAM.