QUEER ISLAND(S): A NEW GROUP FOR QUEER BIPOC IN THE CARIBBEAN COMMUNITY INTEREST FORM

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Welcome fellow Queeribbeans to Queer Island(s)! This group is for folx who identify as bipoc(Black/Indigenous/Person of Color), Queer and/or Trans*, and are apart of the Caribbean Community(by this, we mean countries that are members of CariCom: Antigua and Barbuda, Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, and Trinidad and Tobago.) Please fill out this interest form and we'll be in touch soon. Take care! <3

NOTE: The start date for this group has been postponed. We will reach out to you to schedule an intake as we get closer to the new start date.

Name:

Pronouns:

Email:

Phone:

Age:

Race:

Sexual Orientation:

Gender Identity:

Caribbean Identity:

What are you looking to experience(or discuss any themes/topics) while engaging in this group? *

Are you available Wednesdays at 8:15pm, for 12 weeks, starting in late October? *

Yes

A sliding scale payment between $35 and $80 per session is offered to attend this group. Can you commit to an amount in this range? *

Yes

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