Women's Empowerment Series Online - Registration Form
The NYWC Women’s Empowerment Series is a set of skill-based programs that focus on building women’s strengths and personal power. The series consists of three 9-weeks module: Discovering our Power (DoP), Exploring our Potential (EoP), and Asserting Ourselves (AO).

All new participants must attend an orientation prior to their first program.

The intention of this form is to get an initial understanding of our potential participants. Please complete this form and we will contact you as soon as possible. After completing this form, you will be invited to an intake interview. The interview meeting is a friendly and welcoming space where we get to know you, and you can address all of your questions and concerns.

If you have any questions or concerns, contact the Program Coordinator Taraneh Vejdani at taraneh@nywc.org

** all the information collected is confidential
Email address *
First Name *
Last Name *
Postal Code *
Phone Number
Which program are you interested in joining? (Note: you cannot join a group that you have completed before) *
What motivated you to join the program? *
Do you have regular access to internet and technology?
Clear selection
Do you have a safe and comfortable space to join the group?
Clear selection
What is your level of comfort with using Zoom as a communication tool?
Never Used it before
Very comfortable
Clear selection
How did you hear about this program? *
Any comments or concerns?
A copy of your responses will be emailed to the address you provided.
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