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NOIR / NUbian

Application Form

Let's start with your personal details.

*

Are you applying to join NOIR (male-identifying), or NUbian (female-identifying) cohort?

Untitled multiple choice field

A

NOIR

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B

NUbian

Age

Untitled multiple choice field

A

18-23

*

B

24-32

C

33-40

D

51+

Location where you mostly reside

*

Are you currently employed?

Untitled multiple choice field

A

Yes, Full-time

*

B

Yes, Part time

C

No

*

What are you looking to discover through NOIR or NUbian?

*

What do you hope to gain from participating in this program?

*

Can you commit to attending 4-6 out of 6 sessions, In-Person at our Tulsa, Oklahoma location?

Untitled multiple choice field

A

Yes, I can attend 4-6 sessions in-person

*

B

No, I can not attend 4-6 sessions in-person

How did you hear about us?

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If you were referred by someone, please list who