SIRIA Team Intake Form

SIRIA Team Intake Form

Welcome! Join the Sistèm rezo inisyativ ayisyen (SIRIA) – a collaborative network dedicated to supporting systemic improvements in Haiti through research, advocacy, and action. Please share a bit about yourself and how you’d like to contribute. Your information will help us connect and collaborate effectively.
Full Name (optional but recommended, you can use a nickname if preferred)

First NameLast Name
Email or Preferred Contact Information*
Are you a student or professional?*
Please specify if Other for Are you a student or professional?
If a student: What are you planning to major in?
If a professional: What field are you currently in and what did you major in?
Availability (please indicate how much availability you possess.)*
How would you like to contribute?*

ResearchPlanningFieldworkAdvocacyTechFinanceCommunicationOther
Please specify if Other for How would you like to contribute?
What is your hope for SIRIA? What do you hope it'll achieve?
Comments or Notes (optional)
Thank you for your interest in collaborating with SIRIA! I appreciate your willingness to support systemic improvements in Haiti. We’ll be in touch soon.

For any questions or further contact, please reach out to anlijean08@gmail.com.
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