Pivot Calgary - Application Form

General Information

Hello, and welcome to PIVOT! This is a program designed to build capacity for GBTQ2S+ (gay, bi, trans, queer, two spirit) guys in community advocacy, with a focus on public health. We are excited to hear from you about your interest in this program. This program is presented in Calgary by the Centre for Sexuality in partnership with the Community Based Research Centre for Gay Men's Health.

If you have any questions about the program or the application, please contact nhill@centreforsexuality.ca

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* 1. Name

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* 2. What pronouns do you use? (ie. he/him, they/them, ze/zir, etc.)

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* 3. Age

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* 4. Email Address

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* 5. Phone

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* 6. Which of these is the best way to reach you?

Phone

Either

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* 7. Accessibility Needs (ie. captioning, interpreter, wheelchair access etc.)

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* 8. Dietary Restrictions (ie. vegetarian, gluten free, nut allergy, etc.)

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* 9. In your own words, how would you describe your identity (sexuality and/or gender)?