Penpal POC invites you!
Penpal POC allows system-impacted Psyches of Color youth (POCs) connect with other system-impacted POCs to instill hope and remind them that we are not mentally and/or physically free until we all are. Individuals identify as being system impacted when a system (e.g., carceral, foster care, school, hospital) has impacted their mental health to some degree. People can be directly (i.e., your experiences) or indirectly impacted (i.e., others’ experiences). Writing is an opportunity to have progressive discussions on life beyond system impact. This also provides the opportunity for POCs to share experiences and bring voices together to advocate for more opportunities to reform.
Sign in to Google to save your progress. Learn more
Name *
Age *
Pronouns *
Gender Identity (ask about trans identity so that we can take that into account if pairing you with someone or in helping you through this programming) *
Email *
Phone Number *
Preferred Method of Communication *
Instagram handle *
Would you like to be added to our instagram community to learn more about our programming and to stay up to date with POC programming and other announcements? *
What city and state do you reside in? *
What is your racial-ethnic background? *
How did you hear about us? *
What discussions are you interested in having? *
What are you hoping to gain from joining Penpal POC? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Psyches of Color. Report Abuse
Google Forms