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Research Intake Form: Every Child Belongs Research Project

Introduction

Thank you for taking the time to complete this intake form your input is greatly valued and will contribute meaningfully to inform public policy and improve early childhood education practices to better support Black children with disabilities and their families.

This research project amplifies the voices of Black parents, guardians, caregivers, and Educators of Black children with extra support needs in Early Learning and Childcare settings and EarlyOn settings in Toronto.

We place a high value on your privacy and the confidentiality of your information. Please be assured that all information gathered through this questionnaire will be kept strictly confidential. We will not share your information publicly and we will not link any information that might identify you (e.g. your name or initials) to your interviews.

As a thank you for your participation in this research, eligible participants will receive an honorarium based on your category:
$100 for Black Parents, Guardians, Caregivers, Grandparents and Siblings (18+)

$50 for Black Educators

1.First Name(Required.)
2.Last Name(Required.)
3.Phone Number(Required.)
4.Email(Required.)
5.Do you identify as Black, African, African Canadian, African American, Afro-Caribbean, Afro-Latino, Afro Indigenous and mixed race of African descent.(Required.)
6.I am a(Required.)