Registration ANTE UP! Accountability Course FREE
Welcome! Congratulations on choosing yourself. This form will assist you in registering for your ANTE UP! courses and certification process. For any questions contact Bianca at LatiNegraSexologist@gmail.com. ***THIS COURSE IS OPEN ONLY TO THOSE WHO ARE IMPACTED BY HURRICANES, LIVE IN HURRICANE ZONES BETWEEN JUNE 1 - NOVEMBER 1***

IF YOU WISH TO COORDINATE A PAY AS YOU CAN COURSE WITH ME PLEASE EMAIL ME AT: LatiNegraSexologist@gmail.com -

Email address *
First Name *
Your answer
Last Name *
Your answer
Select all the courses you would participate in: *
Required
Are you available on Monday from July 9 - 23, 2018? *
What times are you available each Wednesday from July 9 - 23, 2018? Check all that apply *
Required
What type of support, if any, may you need for an optimal learning experiences? *
Here is where you may share your accessibility needs (i.e. transcripts from class, subtitles to films, translation support, etc.). If none, please write "None" for your response.
Your answer
Are you willing to agree to all of the core Community Agreements? *
The core Community Agreements are listed on the ANTE UP! website. We will have time in each course to collectively add to these agreements..
Select all that you are comfortable performing for collective support during the course: *
Select all that apply
Required
How did you learn about ANTE UP!? *
Your answer
Are you Puerto Rican? Are you native New Orleanian? Are you living in a hurricane zone July 1 - November 2018? Are you impacted by hurricanes? *
Required
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