*1.Student First Name(Required.)

*2.Student Last Name(Required.)

3.Preferred Name (optional)

*4.Student Email Address(Required.)

*5.Age (as of January 1st, 2026) (Required.)

*6.How do you describe your gender identity?(Required.)

Man

Woman

Trans Man

Trans Woman

Two Spirit

Non-binary

Gender-fluid

Agender

Prefer not to answer

*7.Do you describe yourself as an Indigenous person (including First Nations, Metis, or Inuit)?(Required.)

Yes

No

Unsure

Prefer not to answer

*8.Do you belong to the following race/ethnicity groups? (Select all that apply)(Required.)

Black – African (e.g., Ghanaian, Kenyan, Somali)

Black – Caribbean (e.g., Jamaican, Trinidadian, St. Lucian)

Black – North American (e.g., Canadian, American)

Indian – Caribbean (e.g., Guyanese & Trinidadian)

Mixed or multiple ethnic groups (e.g., White and Black)

Mixed or multiple ethnic groups (e.g., Black and Asian)

*9.What is your street address?(Required.)

*10.City(Required.)

*11.Postal Code(Required.)

*12.What high school do you attend?(Required.)

*13.What grade are you in?(Required.)

*14.Parent/Guardian Contact First Name(Required.)

*15.Parent/Guardian Contact Last Name(Required.)

*16.Parent/Guardian Contact Phone Number(Required.)