Anda_2 Facilitators
Email Address: *
Full Name: *
Preferred Pronouns: *
Phone Number: *
Birthdate: *
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How do you identify yourself as *
Required
Please identify the geographic neighbourhood(s) in the Greater Toronto and Hamilton Area you are engaged with (living, working, historical, etc). Be specific about your relationship with each neighbourhood: *
Do you identify with any marginalized groups (BIPOC, 2SLGBTQ+, Deaf Persons, Persons with Disabilities and Persons Living with Mental Illness, etc.)? If so please self-identify below (optional)
Social Media / Websites / LinkedIn: *
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