Basic Information

To better understand the diversity of the Connected Minds applicant pool and create a more inclusive funding program, we are asking individuals to provide self-identification data.
This form must be completed prior to the application deadline posted on the Connected Minds website.
Even if you are choosing not to self-identify, have chosen not to self-identify in the past, or you do not identify as belonging to any of the following groups we invite you to complete the self-identification form. 
If you have any questions, please feel free to email Andrew Castillo (drewcast@yorku.ca), EDI and Community Outreach Specialist for Connected Minds.

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* 1. Name (First Last)

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* 2. Please select one of the following options that best describes your situation:

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* 3. Name of Supervisor (First Last)

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* 4. Department (if applicable)

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* 5. If you wish to not self-identify, click here:

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