Peer Counselors ONLY

WIC Breastfeeding Curriculum Level 2: Registration Request

Please complete the form below to request registration for WIC Breastfeeding Curriculum Level 2 for Peer Counselors. You must click "Submit" at the bottom of the page to complete the registration request.

Review the WIC Breastfeeding Curriculum Level 2 for Peer Counselors FAQ here.

* Indicates required field.

Contact Information

First Name *

Last Name *

Preferred Name (optional)

Please provide the correct mailing address. This address will be utilized for the shipment of training materials.

Street Address *

Address Line 2

City *

State *

Zip Code *

Work/Daytime Phone Number (including area code): *

Work/Daytime Email Address *

Please Re-enter Your Email Address to Confirm *

Employer Information

Are you currently employed with a local WIC agency? *

Yes

No

WIC Breastfeeding Support Level 2 welcomes individuals who are not employed at a local WIC agency. Please enter the name of your employer or the community partner organization you volunteer with to provide breastfeeding support. *

Select the name of the local WIC agency where you are employed from the drop-down list below. *

Upload a copy of your NC WIC Breastfeeding Curriculum: Level 1 training certificate. *

Supervisor's Contact Information

Supervisor's First Name *

Supervisor's Last Name *

Supervisor's Work Phone Number *

Supervisor's Email Address *

Please Confirm Your Supervisor's Email Address *

Secondary Contact's Information

Participants who are not employed with a local WIC agency must provide contact information for a secondary contact, such as your supervisor's information, community partner contact, etc. The individual will only be contacted in the event that we are not able to reach you.

Secondary Contact's First Name *

Secondary Contact's Last Name *

Secondary Contact's Phone Number (Work Number Preferred) *

Secondary Contact's Email Address (Work Email Address Preferred) *

Please Confirm Your Secondary Contact's Email Address *

Training Session Dates

Each training session will close 10 calendar days prior to the scheduled dates.

Training Schedule and Format: This training is comprised of both virtual (Days 1, 2, 5, and 6) and consecutive in-person (Days 3 and 4) days. Participants are required to travel to the training location for the in-person days.

If you have questions, contact the WIC Lactation Area Training Center for Health whose training session you will be attending:

Please request the training session you would like to attend. *

(CLOSED) October 1, 2, 8, 9, 22, and 23, 2024 (Greenville, NC) (0 remaining)

November 6, 7, 13, 14, 20, and 21, 2024 (Asheville, NC) (4 remaining)

January 14, 15, 21, 22, 28 and 29, 2025 (Charlotte, NC) (15 remaining)

February 4, 5, 12, 13, 26, and 27, 2025 (Greenville, NC) (14 remaining)

March 12, 13, 19, 20, 26, and 27, 2025 (Asheville, NC) (15 remaining)

April 1, 2, 8, 9, 15, and 16, 2025 (Charlotte, NC) (15 remaining)

April 30, May 1, 7, 8, 14, and 15, 2025 (Greenville, NC) (15 remaining)

July 15, 16, 22, 23, 29, and 30, 2025 (Asheville, NC) (15 remaining)

August 12, 13, 19, 20, 26, and 27, 2025 (Charlotte, NC) (15 remaining)

REGIONAL LACTATION TRAINERS:

Region 1

Georganna Cogburn, MS, RD, LDN, IBCLC

Georganna.Cogburn@mahec.net

Region 2

Hannah Edens, MPH, RD, LDN, IBCLC

EdensH@ecu.edu

Region 3

Rachel Dean, MPH, RDN, LDN, IBCLC, RLC

deanra22@ecu.edu

Requirements for Participation

By checking the boxes below, you are confirming that you meet the requirements for participation outlined in the WIC Breastfeeding Curriculum Level 2 for Peer Counselors training FAQ (Questions 1-2 and 19-21)? *

You are currently employed as a Peer Counselor in a local WIC agency

You have completed or are registered to complete WIC Breastfeeding Curriculum Level 1 training prior to your scheduled Level 2 training session

You have or will have access to a computer with microphone and video capability

You will not be scheduled for clinic operations on the scheduled training dates

You will have a demonstration breast model for use during the training session

You will have a baby doll or stuffed animal for use during the training session

Requirements for Participation

By checking the boxes below, you are confirming that you meet the requirements for participation outlined in the WIC Breastfeeding Curriculum Level 2 for Peer Counselors training FAQ (Questions 1-2 and 19-21)? *

You will have a quiet space to participate which is free from distractions. Childcare coverage is required for children older than 6 months.

You will have a demonstration breast model for use during the training session

You will have a baby doll or stuffed animal for use during the training session

Registration Request Confirmation

Upon completion of the registration request for WIC Breastfeeding Curriculum Level 2 training for Peer Counselors:

The Peer Counselor and their supervisor will receive an automated email confirming that their registration request has been submitted to the WIC Lactation Area Training Center for Health for the training session selected.
Local WIC agency staff only: Within five (5) business days receipt of the registration request, the WIC Lactation Area Training Center for Health will confirm that the Peer Counselor has successfully completed WIC Breastfeeding Support Level 1 training and email the registration confirmation with information specific to their selected training session.

By signing below, you are verifying that you reviewed WIC Breastfeeding Curriculum Level 2 training for Peer Counselors FAQ and meet all requirements for participation *

clear