InterPride Racism and Oppression Awareness Month Interest Form
Please complete this form if you are interested in contributing content for the ROAM initiative. Please complete the form no later than September 4th, 2020. Please note there is flexibility of dates and times. Please contact Carlos Idibouo - carlos.idibouo@interpride.org, if you have any questions about ROAM.
Organization / Information
Required Sections
Organization Name
City *
Country *
Contact Information
Name of Contact Person *
Email Address *
Telephone Number *
Website/Social Media Links *
Do you organize Pride and/or Pride-related events in your area? *
Required
Activity Application
Required Section: Please add all that apply
Which topic are you interested in presenting? *
Required
What type of activity would you like to take part-in? *
Required
If other, please specify
On what dates will your activity take place? *
Required
Participant(s) Information
Participant #1 (Name/Pronouns) *
Email Address
Participant #1 - Please select which of the following applies: *
Required
Participant #1 - if other, please specify
Participant #2 (Name/Pronouns)
Email Address
Participant #2 - Please select which of the following applies:
Participant #2 - if other, please specify
Participant #3 (Name/Pronouns)
Email Address
Participant #3 - Please select which of the following applies:
Participant #3 - if other, please specify
Participant Recommendations
Please provide the names and email addresses of additional LGBTQIA+ organizations and/or individuals you wish to recommend for this event.
Recommendations
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