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Registration V.2

Thank you for your interest in being a part of The Backbone Collective.  

The information you provide will be completely confidential and will only be accessed by staff at The Backbone Collective office.  

Your information will not be shared with third parties under any circumstances. Please go to our website to read more about how we are keeping you and your information safe.
1. Are you a woman who has ever experienced violence and abuse, i.e. physical violence, sexual assault or abuse, psychological or emotional abuse, financial abuse? *This question is required.
Which of the following describes you? *This question is required.Please select all that apply
  • * This question is required.
We are building the Backbone for women because we think that our collective voice can help bring about much needed system change.  However, it is up to you how much involvement you would like to have. 

Being a member means that we will send you email updates about what we are doing. If you would like to and are able to do more, please tick the boxes that apply.

I would like to: *This question is required.
  • * This question is required.
Thank you for offering to provide your ideas and suggestions.  What would you like to give input on? *This question is required.
  • * This question is required.