Diverstory: Reading for Equity

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

YWCA and Metro East Community Rotary Club are hosting a Diverstory: Reading for Equity session on Saturday, November 18, 2023 at 10:30 am to 11:30 am in the YWCA lobby. Diverstory is a story time where young children and their grown ups come together and listen to children's stories about diversity and engage in guided activities about diversity, belonging and race. Every family will receive copies of the books we read to take home and continue intentional conversations about race.

YWCA is located at 304 E. Third St., Alton, IL.

Diverstory is facilitated by Becky Cowart and Candice Wallace, both educators, Moms and experienced Diverstory faciliators. Ages 2 to 10 years.

For information, please call YWCA at 618.465.7774 or email us at info@ywcaswil.org.

Last Name of Participant *

First Name of Participant

Ages and number of children particpating

Phone Number

Email *

Address *

City, State, Zip Code

The following questions are included for data collection purposes for grant reporting. All data collected will be maintained in a secure location.

Race

Alaskan Native/Native American

African American/Black

Middle Eastern

Native Hawaiian or Other Pacific Islander

White

Multi-racial

Prefer Not to Answer

Other:

Clear selection

Do you identify as Hispanic or Latino

Yes

Clear selection

Gender

Female

Transgender Female

Non-binary

Male

Transgender Male

Prefer Not to Answer

Clear selection

Number In Household (Optional)

Annual Income of Household (total income of household members) Optional

Please identify any types of special assistance you receive

Public Housing Section 8

Special Supplemental Nutrition Program for Women, Infants, Children (WIC)

Supplemental Nutrition Assistance Program (SNAP)

Temporary Assistance for Needy Families (TANF)

Do Not Wish to Disclose

Clear selection

I give YWCA permission to post my child's photo from the Diverstory event on social media for publicity purposes.

Yes

Clear selection

Comments

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms