PLEASE COPY THE FOLLOWING APPLICATION FORM TO A WORD DOCUMENT AND EMAIL COMPLETED APPLICATION TO pam@charlesstreetvideo.com by Sept. 26th, 2011
Queer Connections 2011 Youth Participant
Application Form
Thanks for your interest in the Queer Connections youth
video project! This application is not a test and there are no wrong answers!
We just want to know a little bit about you!!
1.
Name:
2.
Age:
3.
Location (please circle one):
Etobicoke North York Scarborough
4.
What’s your story? Who are you, how do you
identify? What are you passionate about? (max. 250 words)
5.
Why are you interested in being involved in the
queer connections project? Tell us why you want to be part of the program. (max.
250 words)
6.
What do you want people to know about LGBTQ
issues? (max 250 words)
7.
Can you commit to attending workshops twice a
week?
8.
Do anticipate there being any challenges or
barriers to your involvement and participation in this program?
9.
Is there anything else that you want us to know?
Application Submission Deadline: Sept 26th, 2011
Please submit application by email to:
pam@charlesstreetvideo.com
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