LP 2020 PARTICIPANT Application

H.O.W. (Healing Our Wombs): A Black Womb Wellness Garden and Self Healing Project is designed to create a safe space for Black women and girls, where they can come together to learn and teach each other about their sexual and reproductive health through growing foods and herbs at the two Urban Food Forests of Atlanta.

Participant Requirements

1. Live in the residential area surrounding the Urban Food Forest at Browns Mills or the Outdoor Activity Center at WAWA

2. Black / BIPOC woman

This application is for those desiring to participate in the program from June 2021 - March 2022. If you have any questions, please contact Hanifah Shoatz-Bey at (678) 508-3319 Thank you!

Application Deadline - Saturday, May 15, 2021

Upcoming Events:

Tend the Garden - WAWA - Saturday, May 22, 2021 10am-2pm 1401 Bridges Ave SW Atlanta, GA 30310

Womb Wellness Hike at the Cascade Nature Preserve - Saturday, May 29, 2021 10am- 2pm 2852 Cascade Rd SW Atlanta, GA 30312

Tend the Garden - Browns Mill Food Forest - Saturday, June 12, 2021

2217 Browns Mill Rd SE, Atlanta, GA 30315

Full Name*

First NameLast Name

Gender*

FemaleMale

Birthdate*

MonthDayYear

E-mail

Please use preferred email to receive important LP updates!

Cell*

Area CodePhone Number

Ethnicity*

Home Address*

Home Address Line 1

Home Address Line 2

Home CityHome State

Home Zip

Parents'/Guardians' Name(s) (For participants under 18)

Parents'/Guardians' Email(s)

T-Shirt Size*

Do you have your menstrual cycle?*

YesNo

If so, what age did you start?

Have you started Menopause?*

YesNo

If so, what age were you?

Name one plant, herb or food that you can eat that is good for your uterus|vagina. If you don't know that is okay. Put I don't know .*

0/500

Name one health issue for Black women that affects their ability to get pregnant? If you don't know that is okay. Put I don't know .*

0/500

Name one reason Black babies die before their 1st birthday. If you don't know that is okay. Put I don't know .*

0/500

Name one way our body is connected to the land.*

0/500

You have reached the end of the application, please click the submit button below.

Participant Application

Part I: Contact Information