Beauty Inside Out - Parental Permission Registration

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Thank you for your interest in participating in the Beauty Inside Out survey organized by WE ACT for Environmental Justice.

This project aims to understand how girls, women, and femme-identifying people of color in Northern Manhattan and the South Bronx think about and use certain types of cosmetic products.

To participate in the survey, you must:
-Be between the ages of 13 - 17
-A woman or a femme-identifying person of color
-Live in Northern Manhattan (West, Central or East Harlem, Inwood, or Washington Heights) or the South Bronx.

Interested respondents must receive parental permission.

If you meet the qualifications and are interested in the survey, please provide the following information to allow WE ACT to seek parental permission.

If the parent/legal guardian is interested in registering their child, please complete this form with the child's information.

Full Name *

Email Address *

Age *

What gender do you most identify with? *

Female

Male

Non-binary/Genderqueer/Gender Non-conforming

Other

Do you identify as a person of color? *

Yes

Are you from any of the following communities? *

Washington Heights

Inwood

West Harlem

Central Harlem

East Harlem

South Bronx

Other:

Required

Please enter your parent/legal guardian email address. *

If your parent/legal guardian does not have an email address, please enter their phone number. *

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