Community Group Application Form

If your application is accepted, this form will constitute a formal written agreement between you, The Group Member (as detailed on this form), and the Centre for Liberating Practices.

NOTE: The Centre is committed to making our group application process as anti-oppressive, accessible, and inclusive as possible. If you have difficulty with this written application or if you would prefer to apply verbally over the phone, please contact us.

This form uses a structure called "conditional logic", which means the form changes based on your responses. If you select an answer choice that refers to a comments box, you will not have access to that comments box until after you have selected that response.

Section 1: About your group

Please note that you will generally need to submit a separate application form for each group. However, sometimes we might waive this policy and invite you to more than one group with only one application. Waiving this policy is a decision we might make, based on the content in your application and/or our Team's direct experiences of interacting with you.

The group for which I am currently applying is... *

Larger bird sheltering another bird in the caring embrace of its wings, while surrounded by air currents and natural movements. This image symbolises how communities of care prioritise equitable sharing of emotional and other forms of support.

Image of tree with multiple birds in different shades on different branches, with the polyamory symbol of a heart with an infinity symbol wrapped around it and the words Polycules in Partnership® at top and bottom in curved text

A colourful swirl background on which the words "The ND GBKS Collective" appear in stylish comic book style font that signifies the fun and informal nature of this group. The colourful background contains a rainbow of colours that is representative of both the GBKS community and the diverse spectrum of neurodivergent lived experiences.

Three hands in a circle, with the top hand holding a quinoa flowering plant, the lower right hand holding a growing seedling in soil, and the lower left hand holding a loaf of bread. Inside this circle of hands is a heart outline formed by three clockwise arrows. This image represents a solidarity economy as an alternative to capitalism.

A four-panel collage: Top left, pencils beside a notebook sketch of a feather; top right, a colourful artist’s palette with brushes blending hues to create new shades; bottom left, an acoustic guitar and drum set on stage at an indie music event; bottom right, two people dancing with raised arms under warm lighting. This collage symbolises the diverse forms of creative and expressive arts that our community nourishes and is nourished by.

How did you find out about this group? *

Are you aware of any existing connections with current members of this group? *

What are 3 or more reasons you want to join this group? *

What are 3 or more of your lived experiences that you feel are relevant to this group? *

Which 3 or more privileges, assumptions, and/or challenges might you experience in this group? *

What kind of support would be helpful to you in navigating these challenges you might encounter in this group? *

What, if any, prior challenges have you experienced in group spaces, and what are 3 or more ways you hope this group will be different? *

Our 19 Agreements: We ask all people joining our community or attending any of our community groups to be familiar with and commit to applying our 19 Agreements here: https://liberatingcentre.info/community/#agreements

NOTE: Please refer to our 19 Agreements when responding to this question.

Which of our 19 Agreements do you feel is most likely to be challenging for you, and what kind of support do you feel would help you to manage this challenge? *Please review our 19 Community Agreements on our website before you answer this question: https://liberatingcentre.info/community/#agreements

Section 2: About you

Name you wish to use in this group *

How to say your name correctly *If you are a person with hearing and speaking privilege, then you can also create a free audio Name Badge through Name Coach: https://cloud.name-coach.com/namebadge/

Your pronouns in English (if any). Pronouns are words we use in place of nouns, such as when we describe people. *

Name you want listed on any group correspondence visible to other group members *

In which location(s) / time zone(s) will you be based while attending this group? (Explain if multiple locations and, if known, please specify dates and times when you will be in each time zone) *

Your email address *An email account is required for access to this group. Please let us know if this is not accessible for you or you need support to set up your email account.

Section 3: Orientation Process

To support new members of this group, the Centre provides accepted applicants with a welcome chat where you can ask an existing group member question and learn more about this group.

We also provide new members with orientation materials to support you in this space.

Before completing your application to join this group, we require you to review and consent to following our 19 Community Agreements.

Our 19 Community Agreements are available here: https://liberatingcentre.info/community/#agreements

I hereby state that I have reviewed the 19 Community Agreements, including the explanations available with a click to expand on each agreement. *

YesNo

If my application to join this group is accepted, I agree to follow the 19 Community Agreements to the best of my ability in all interactions involving this group and any person involved with the Centre. *

YesNo

I understand and consent to participant in the Centre's use of accountable community practices, including disruption practices and accountability processes. *

YesNo

I am aware this means that if something I do is unintentionally oppressve, the facilitator(s) will intervene as immediately as possible to disrupt this behaviour, and that this is intended as a non-punitive and supportive way that our community addresses harms that occur in a group setting. *

YesNo

In addition to offering me a welcome chat with a person involved in this group, I understand that the Centre will be sending me a separate Accessibility Needs Form to address any neurodivergent, disability, religious, cultural, personal, carer, and other learning needs to make this group as inclusive, safe, and supportive for me as possible. *

YesNo

Section 4: Affirmative Consent

The Centre for Liberating Practices has a trauma-and-violence-informed care (TVIC) approach that is survivor-centred, intersectionally feminist, anti-stalking, and aware of coercive control abuse dynamics.

No one is entitled to access to our private community, our groups, or our spaces without our affirmative and ongoing consent. We are a carefully curated community that cares about the safety and wellbeing of all our members.

Our Vetting Process

By applying to this group, you give consent for your name to be shared with current group members, for the purposes of identify any potential conflicts of interest or multiple relationships that might interfere with existing group members' participation (e.g., if you are the therapist or clinical supervisor of an existing group member and/or one of their intimate partners, polycule members, and/or close kin). If we have this type of concern, we will notify you without sharing specific details about our current group members. You can still be added to our newsletter to receive our free monthly resources.

By applying to this group, you give consent that, if we become aware of any actual or perceived concern related to the safety of our team and/or other people involved with the Centre, for us to reject your application or rescind your acceptance to this group, without disclosing any information that could endanger the safety of anyone in our community.

Please be aware that if you have stalked, intimidated, or harassed any member of our team or our community without completing an accountability and restorative justice process with which they feel satisifed, we reserve the right not to reply to your application at all for safety reasons.

I understand and agree to the safety measures above. *

YesNo

To the best of my knowledge, I confirm that the information contained in this form is accurate and complete at this time. *

YesNo

I give permission for my full personal name (and the name of my workplace if provided) to be shared with current group members for the reasons explained above. *

YesNo

If accepted to join this group, I understand and give consent for my email address to be visible on meeting invitations shared with all group members. *

YesNo

I understand that, for the safety of the Centre community and the people within it, the Centre may check my public online profile through a web browser search as part of screening to ensure that people who engage in hate speech, vilification, bullying, and other interpersonally violent conduct that violates our Community Agreements are not accepted to our groups. *

YesNo

Sign here using either draw or type-to-sign options (If you are using a screen reader, then you will need to tab down below the draw box to select type-to-sign) *

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