In This Together - Registration Form

In This Together is a weekly, online based support group for BIPOC and Newcomer/ Refugee youth, designed to promote positive mental health. This project will offer youth ages 16-25 with 1.5 hour weekly sessions, that are aimed at identifying personal stressors and necessary coping mechanisms. More specifically, In This Together will use interactive art-therapy based methods to provide youth with the capacity to combat the isolation and uncertainty that COVID-19 has brought forth.

This project is funded by RisingYouth TIG (Gov't of Canada and Canadian Service Corps) and lead by Abrar Trauma and Mental Health Service.

If you have any questions or concerns please email abrar@abrarmh.ca
Email *
Full Name *
What is your age: *
Required
If you are under 18, do you have a trusted adult in your life who you can debrief with? *
(City, Province) you currently reside in? *
Do you identify as a visible minority? *
Do you identify as a/an :
Clear selection
What is the Ethnic or Cultural Origin of your Ancestors? (Please check all that apply) *
Required
What are you seeking to gain from the youth focus group "In This Together" (4-week sessions) ?
Do you have an interest in or practice any form of art? (E.g. Painting, Drawing, Writing, Poetry, Music, Photography, Dance, etc.) ?
Provided that sessions are 1.5 hr/week, for 4 weeks, would you be able to commit to participating for the duration of the program sessions? *(Sessions are scheduled on weekends). *
If you answered Yes to the above, please specify below which time slots would you prefer during weekends? *
Required
Any additional information or comments you would like us to know?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy