history Registration form education Register now! 2SLGBTQ+ History Program: Student Registration Form Hi! Thank you for your interest in participating in the 2SLGBTQ+ Canadian History Program run by the Canadian Centre for Gender and Sexual Diversity with support from the Department of Canadian Heritage. Please complete the form below to receive your FREE EDUCATIONAL MATERIALS PACKAGE. Questions or concerns? Contact the Program Coordinator, Celeste Lessard-Kragen: email@example.com. This information is collected for the purposes of data collection and reporting. Step 1 of 3 33% Name* First Last PronounsExample: She/Her, They/Them, He/HimEmail* How old are you?*14-1819-2425-2930+Where are you located?*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonOtherHow do you identify? (optional)FemaleMaleNon-BinaryGenderqueerGenderfluidPrefer not to sayOther genderIf you are participating through a school or organization, what is it called?How did you learn about this opportunity? Material Use* I understand that I must use these learning materials before 31 May 2021.I agree to complete a brief evaluation form to provide feedback and collect demographic information. (Note: this form is provided by our funding partner and the information collected is anonymous and will only be used internally. Completing the form is important to help us continue to run programs like this one).* Yes, I agree. No, I prefer not.