In Reach Registration
In Reach is a no-cost program for rural women and gender-diverse folks of all ages, coming together to share skills, resources, ideas, perspectives, experiences, and information. 

There will be three groups gathering together; one group per region (western, central and eastern.) Groups will each have an initial meeting in December 2022, and then meet once a month in the Winter of 2023. 

Meeting Locations:

West: Mill River Resort (180 Mill River Resort Rd.)
Central: Breadalbane Community Library (4023 Dixon Rd, Breadalbane)
East: Little Pond Community Centre (2547 PE-310 Cardigan)

Registration is required and space is limited. Application close on November 25, 2022.

If you have any questions regarding In Reach or need assistance completing this form, you can contact Rachel at 902-598-8708. 

This program is facilitated by Women's Network PEI and is funded by Women and Gender Equality Canada (WAGE)
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#1 Which In Reach location are you interest in attending?  *
#2 Full Name *
#3 What are your gender pronouns? (In Reach is open to women and gender-diverse people.)

*Gender pronouns are the terms people choose to refer to themselves that reflect their gender identity. These might be he/him, she/her or gender-neutral pronouns such as they/them.
 *
#4  Email *
#5  Phone Number *
#6  We may need to contact you with follow up questions regarding your answers, or to communicate information about the program. What is the best way to contact you? *
#7  What town do you currently live in? (If you don't live in a town please provide the closest town to your home.) *
#8  Please select your age range. *
#9  Anything we can do to make this program more accessible for you? (i.e. dietary restrictions, accessibility concerns, language needs/supports)

**Please note lunch is provided during the program so if you have any food restrictions or dietary needs please list them here)
 *
#10  Please check if you require a subsidy to help with childcare cost.  (Travel subsidies are provided to all participants)
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#11  Why are you interested in participating in the In Reach program? What do you hope to get out of this experience? *
#12  How did you hear about In Reach? (Check all that apply)
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