Young Black Women's Project Registration Form (Summer 2026)

The Young Black Women's Project is a leadership program for African, Caribbean, and Black women, women-identifying and gender-diverse individuals in the Peel Region! Over the course of 8 weeks, you will get the chance to build capacity in advocacy skills, wellness strategies, career-building skills, as well as learning more about sexual health and destigmatizing sexual wellness. Participants who complete the 8 weeks will receive a certificate AND a wellness package packed with lots of cool goodies, but overall the support to help you become the most successful Black womxn you can be!

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1. Please provide your first and last name. (Required.)

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2. Please indicate your age. (Required.)

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3. Please provide your email address. (Required.)

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4. Please provide your address. (Required.)

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5. Please provide your cellphone number. (Required.)

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6. Do you identify as African, Caribbean, and/or Black? (Required.)

Yes

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7. Please state which gender you identify with. (Required.)

Cisgender Woman

Trans Woman

Cisgender Man

Trans Man

Non-Binary

Gender Diverse

Two-Spirit

Do Not Know

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8. Are you an Indigenous individual? (Required.)

Yes, First Nations.

Yes, Inuit.

Yes, Métis.

No, I am not.

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9. Are you available for the following dates from 6:00pm-8:00pm:
Thursday June 11, 2026
Thursday June 18, 2026
Thursday June 25, 2026
Thursday July 2, 2026
Thursday July 9, 2026
Thursday July 16, 2026
Thursday July 23, 2026
Thursday July 30, 2026 (Required.)

Yes, I can attend all of these sessions.

I can attend some but not all.

No, I cannot attend any of these sessions.

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10. Why would you like to participate in the Young Black Women's Project? (Required.)

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11. Are you willing to participate in group conversations and activities around self-care, sexual wellness, and leadership skills? (Required.)

Yes

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12. This series will be hybrid and will feature both in-person and online sessions. All sessions will be virtual except the graduation ceremony that will take place in-person at 7700 Hurontario Street Unit 601 Brampton, ON. Are you able to access both in-person and online sessions?

Yes

I can access virtual but not in person sessions.

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13. Do you have any accessibility needs we should be aware of? If so, please outline what these needs are. (i.e subtitles on ZOOM, transportation needs to in-person sessions, etc.) (Required.)

Young Black Women's Project Registration Form (Summer 2026)

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* 1. Please provide your first and last name. (Required.)

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* 2. Please indicate your age. (Required.)

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* 3. Please provide your email address. (Required.)

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* 4. Please provide your address. (Required.)

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* 5. Please provide your cellphone number. (Required.)

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* 6. Do you identify as African, Caribbean, and/or Black? (Required.)

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* 7. Please state which gender you identify with. (Required.)

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* 8. Are you an Indigenous individual? (Required.)

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* 9. Are you available for the following dates from 6:00pm-8:00pm:Thursday June 11, 2026Thursday June 18, 2026Thursday June 25, 2026Thursday July 2, 2026Thursday July 9, 2026Thursday July 16, 2026Thursday July 23, 2026Thursday July 30, 2026 (Required.)

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* 10. Why would you like to participate in the Young Black Women's Project? (Required.)

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* 11. Are you willing to participate in group conversations and activities around self-care, sexual wellness, and leadership skills? (Required.)

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* 12. This series will be hybrid and will feature both in-person and online sessions. All sessions will be virtual except the graduation ceremony that will take place in-person at 7700 Hurontario Street Unit 601 Brampton, ON. Are you able to access both in-person and online sessions?

Question Title

* 13. Do you have any accessibility needs we should be aware of? If so, please outline what these needs are. (i.e subtitles on ZOOM, transportation needs to in-person sessions, etc.) (Required.)

1. Please provide your first and last name. (Required.)

2. Please indicate your age. (Required.)

3. Please provide your email address. (Required.)

4. Please provide your address. (Required.)

5. Please provide your cellphone number. (Required.)

6. Do you identify as African, Caribbean, and/or Black? (Required.)

7. Please state which gender you identify with. (Required.)

8. Are you an Indigenous individual? (Required.)

9. Are you available for the following dates from 6:00pm-8:00pm:
Thursday June 11, 2026
Thursday June 18, 2026
Thursday June 25, 2026
Thursday July 2, 2026
Thursday July 9, 2026
Thursday July 16, 2026
Thursday July 23, 2026
Thursday July 30, 2026 (Required.)

10. Why would you like to participate in the Young Black Women's Project? (Required.)

11. Are you willing to participate in group conversations and activities around self-care, sexual wellness, and leadership skills? (Required.)

12. This series will be hybrid and will feature both in-person and online sessions. All sessions will be virtual except the graduation ceremony that will take place in-person at 7700 Hurontario Street Unit 601 Brampton, ON. Are you able to access both in-person and online sessions?

13. Do you have any accessibility needs we should be aware of? If so, please outline what these needs are. (i.e subtitles on ZOOM, transportation needs to in-person sessions, etc.) (Required.)