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Cape Breton GSA Virtual Drop-In Registration
This is the registration form for the Cape Breton Youth Projects monthly Virtual GSA meet-ups! Please note some of the demographics information here is collected for use in future funding applications to run programs just like these. This information is strictly accessible to The Youth Project and will not be shared for any other reason. Any information used would be made anonymous and only made to give a snapshot of the backgrounds and intersections of the folk we serve. On many of these questions you will have the right to pass. Disclosing demographic information is not required to join our programs!
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Email
*
Your email
First Name:
*
(the name you go by)
Your answer
Last Name:
*
(the name you go by)
Your answer
Age:
*
Your answer
Full name of your school:
*
Ex: Riverview Rural Highschool; Sydney Academy; Sydney Mines Middle School; etc
Your answer
Your grade level:
*
(6th, 7th, 8th, 9th, 10th, 11th, 12th)
Your answer
Does your school have a GSA?
*
Yes
No
Other:
Phone number in case we need to contact you outside of email:
Your answer
How will you be joining us on Zoom?
Laptop/Desktop Computer
Tablet
Smartphone
Available technology at a public service (Ex: Library; etc)
Other:
Your Gender Orientation or Gender Identity:
Please self-describe! Lists for these questions can be restrictive :) Ex: Cis-Male; Trans Woman; Demi-girl; Non-binary; GNC; Gender-fluid; etc
Your answer
Your pronouns:
Please self-describe! Lists for these questions can be restrictive :) Ex: Cis-Male; Trans Woman; Demi-girl; Non-binary; GNC; Gender-fluid; etc
She/Her
He/Him
They/Them
Other:
Your Sexual Orientation:
Please self-describe! Lists for these questions can be restrictive :) Ex: Gay; Queer; Lesbian; Asexual; Bisexual; Pansexual; etc
Your answer
Your racial backround:
Please self-describe! Lists for these questions can be restrictive :) Ex: African Nova Scotian or Black; Mi'kmaq or First Nations; white or Caucasian; Indian; Asian; Latinx; etc
Your answer
Your city/town/community:
We don't need your full address, just where you are from! Ex: Sydney; Eskasoni; Arichat; Membertou; Glace Bay; North Sydney; Inverness; etc
Your answer
Accessibility needs:
Are there any accommodations you need to participate in our programming
Your answer
What do you hope to get from attending this virtual program?
Your answer
Do you have any suggestions for activities or actions to come from this program?
Ex: Movie streaming; youth lead education campaign; games we can do online together; etc.
Your answer
Name & Number of an emergency contact:
In the event that we need to get a hold of someone we need an emergency contact. With virtual programming this is not likely, but in case we need to keep you safe this is important. Please let us know who this person is to you (Ex: Mom; sibling; etc). If you need us to use a different name when speaking to them (Different from the name you provided in this form) let us know here. If you need to assume a different identity (Ex: Straight Ally; Cis guy) in the event we needed to call let us know here. We never wish to accidentally out someone before their time.
Your answer
Have any questions for us?
Your answer
Is there anything else you would like to let or know, or think we need to know?
Your answer
We are excited to have you sign up! These meetings will be on the 3rd Tuesday of every month! These meetings will run from 6:30 p.m. until 8:00 p.m. After registering we will be in touch over email to send you the joining information for Zoom. The link we send you can be used for EVERY drop-in so make sure to hold on to it and not share it with others.
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