Rooted Connections

Student Life will be facilitating a Black History Event at the Stoney Creek campus called Rooted Connections

First Name:

Last Name:

Student Number:

Mohawk Student Email:

Do you require any accommodations for this event (physical, visual, auditory)

Do you have any dietary accommodations or severe allergies?

Which of the following would you self-identify being (select all that apply)

Afro Latino/Latina/Latinx

Afro Indigenous

Afro Caribbean

West Indian

Bi-Racial/Multiracial

African

Other…

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