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Totally Outright Program Intake Form

Totally Outright Description

Totally Outright at Moyo is a holistic, 16-session, certificate-based capacity-building program for 2SLGBTQ+ adults (18+) in Peel who want to learn, connect, and grow in a supportive space. Together, we explore sexual, mental, emotional, and physical health — while unpacking the role of culture, identity, and community.

Please contact Lead Coordinator Anurag Khunger for further details.

Phone Number: (905) 867-6379 (Ext 225)
1.Are you 18+ and of age of majority?(Required.)
2.What is your first and last name? (Anonyms Allowed)(Required.)
3.What is the age range most applicable to you?
4.What are your pronouns?
5.Which gender identity or gender expression best describes you?
6.Do you identify with an Indigenous Background?
7.What is your email address? (For Contact)(Required.)
8.What is your primary phone number? (For Contact - Call and Text)(Required.)
9.Do you have any accessibility requirements? (If Yes: Please Indicate)
10.What inspired you to join the Totally Outright Program?(Required.)
11.Would you be willing to engage in knowledge-building topics involving sexual health, decision making, and self-confidance?(Required.)
12.Please select the preferred coordinator of primary contact...
13.How did you hear about the Totally Outright Program?(Required.)