Participant Registration Form
Hi! Thank you for your interest in participating in the "We Belong: Celebrating 2SLGBTQ+ History" program!

Please complete the form below to reserve your place.

The forum will have both ASL & LSQ interpretation

The final forum is open to any youth 12-19 or monitors living in Canada.

In this form, we’ll be collecting some of your personal information. All personal information we collect is strictly confidential and kept anonymous. We collect this information to better understand how we can best serve you as a participant and to know who is engaging with our programming or attending our events. Information collected in this form will be compiled with other responses and shared with our funder, the Canadian Ministry of Heritage, but you will never be identifiable based on your personal information. Your answers in this form will be kept for 5-10 years and then deleted.

You will also be asked to complete feedback surveys on a few occasions after the forum, all of which are also anonymous.  

If you have any questions or concerns before completing this form, please reach out to the Program Coordinator: myloe@ccgsd-ccdgs.org or 613-400-1875.

Thank you!
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First and last name *
Pronouns (They, She, He, or how you want to be referred to in the third person) *
Email address (Please indicate if you are using a guardian's email) *
*If you register with a school email, we won't be able to be in touch with you because the school network blocks outside emails. Please use a personal email if possible or include a monitors email. The email you provide will only be used to send you information related to We Belong unless otherwise indicated in the next question.
Would you like to receive emails from CCGSD about future programs, activities, and resources similar to We Belong? *
How old are you? *
I understand that if I am 16 year or older (14 in Quebec), my personal information is collected and held by the organization through this registration form. The information is kept confidential and will only be shared anonymously. *
In this form, we’ll be collecting some of your personal information. We collect this information to better understand how we can best serve you as a participant and to know who is engaging with our programming. Information collected in this form will be compiled with other responses and will be shared with our funder, the Canadian Ministry of Heritage, but your information will always remain anonymous. We might also use anonymous information to create statistics about the event that could help us explain our programming to funders, donors, and the community. Your answers in this form will be kept for 5-10 years and then deleted.
Are you participating independently, with a school or class, or with a group or organization? *
If you are participating through a school or group, please specify the name of your school or group, the name of your teacher or supervisor, and their contact information (email): *
What province or territory do you live in? *
Please select the date and time of the forum you wish to attend: *
Required
What is your preferred language of communication? *
How would you describe your gender identity? Select all that apply: *
Required
How would you describe your orientation? Select all that apply: *
Required
What languages are spoken in your home? (Check all that apply) *
Required
Do you identify as Black, Indigenous, and/or a person of colour? (Please check all that apply) *
Required
Feel free to expand on your answer to the previous question, or share any details you would like that describe your ethnicity, race, or place of origin. (e.g. Mexican and Italian, Middle Eastern from Egypt, Black Caribbean from Haiti, adopted from China but parents are Irish etc.)
Do you identify as a person living with a disability/Disabled person, a person living with chronic pain, and/or a person living with a mental health/mood disorder? *
If you identify as a person with a disability/disabled person, or someone who needs additional support, please let us know what accessibility needs you would like us to be aware of (this might include ASL or LSQ, alternative communication tools, and/or other support needs)
How did you learn about this opportunity?
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