PoBC Education Contact Form

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Thank you for contacting Parents of Black Children Education Team.

We aim to respond to your requests within three business days.

Please complete the form below so that we are better able to serve you.

Full Name *

Phone Number *

Email address *

Please indicate if you are a: *

Parent/Guardian

Teacher/Educator

Community Organization

Referral - from Education System Navigator

Referral- from Child Welfare System Navigator

Other:

What grade is your child in/do you teach? *

What school board is/are your child(ren) a student in/ do you teach in? *

What support are you looking for? *

Tutoring

Teaching resources and lesson plans

Questions about PoBC education workshops

Other:

I understand that the information collected in this form will be used by Parents of Black Children to provide support to me. *

Yes

I consent to Parents of Black Children's Education team sharing my information with Parents of Black Children System Navigators if additional support is required. *

Yes

I understand that if support is required outside of Parents of Black Children, I will be required to sign a consent form. *

Yes

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