Get Active! Physical Literacy for Women 2023

Program Application

Thank you for your interest in Get Active! Applications are being accepted until August 27, 2023 at 11:59 p.m.

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* First and Last Name

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* Preferred name?

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* Phone Number

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* Email

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* Home Address

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* Are you between the ages of 19-55 years?

Yes

No

Other (please specify)

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* What are your pronouns? (Click all that apply)

She/her/hers

They/them/theirs

Other (please specify)

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* Are you an immigrant to Canada?

Yes

No

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* Year of immigration (if applicable)

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* What is your cultural background?

African

European

East Asian

South Asian

South East Asian

First Nations or Indigenous

Hispanic or Latinx

Middle Eastern

Prefer not to answer

Other (please specify)

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* In 300 words or less, please describe why you want to join the Get Active! program? What barriers prevent you from participating in physical activity? What are you hoping to get out of the program? (Answering this question helps in the application process.)

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* Have you participated in UNA's Get Active program previously?

Yes

No

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* I understand I must submit a passing PAR-Q+ form or have medical clearance from a qualified exercise professional to be able to participate in the program.

Yes