Your goodVillage Espresso Milk Collective Pre-Registration Form
Once you have completed the pre-registration form, you will receive a zoom link to register for the virtual Black breastfeeding support group. Your goodVillage Espresso Milk Collective was created to address the racial disparities the exist in Black breastfeeding in a culturally safe space. If you do not meet this criteria and are interested in receiving breastfeeding support, please contact us for resources at 888-357-2366.
*By providing your phone number, you consent to receiving automatic text messages for upcoming events and event reminders. Text HELP for info. Text STOP to quit.
This group was created as a safe space due to the disproportionate high rates of Black maternal and infant mortality and breastfeeding disparities. Do you self identify as a person who is Black/African American?
First and Last name
Please indicate the city in Michigan where you reside
Are your pregnant?
Are you currently breastfeeding?
Which day/time are you interesting in attending? (Check all that apply)
4th Tuesdays 11am-12pm
2nd Wednesdays 6pm-7pm
How did you hear about Your goodVillage Espresso Milk Collective?
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Your goodVillage Collective.