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Creation Scaling Grants Stream (Scal.Pro-Jul.24) – Demographic Form
Creation Scaling Grants Stream (Scal.Pro-Jul.24) – Demographic Form
2024-09-24T13:25:33-04:00
Questionnaire Below
Which project are you a member of? (Select one)
*
Wolverines Hockey - Wikwemikong Wolverines Women and Girls Hockey
Wabanaki Two Spirit Alliance - Establishing Two Spirits of Unama’ki (2SU)
Inawendiwin - Inawendiwin: The Connection Project
NSCAD Treaty Space Gallery - Treaty Space Gallery – Indigenous Student Centre
Jason Wolbert - Niswi Oshkaabewis
The name of the organization is provided by the activity leader(s).
Have you ever participated in a IYR program, activity, or event before?
*
Yes
No
Unsure
Prefer not to say
If you have, how many times?
*
Once
Twice
Three times or more
Unsure
Prefer not to say
Please enter your current postal code (e.g. A1B2C3):
Which of the following best describes where you currently live?
*
Urban
Rural
Remote
On-reserve
Prefer not to say
Which of the following genders do you identify with? (Select all that apply)
*
Cisgender woman
Cisgender man
Transgender woman
Transgender man
Non-binary
2-Spirit
Agender
My gender is not listed here
Prefer not to say
Do you identify with any of the genders or sexualities under the LGBTQIA2+ umbrella?
*
Yes
No
Unsure
Prefer not to say
How old will you be when the program starts? Please enter the number representing your age
Which of the following languages do you most often use at home? Select all that apply.
*
English
French
Indigenous language(s)
My language(s) is (are) not listed here
Prefer not to say
What is the highest level of institutional education you have completed?
*
Elementary (Grade 6)
Middle School (Grade 9)
High School (Grade 12)
College Certificate
College Certificate
College Diploma
Bachelor’s
Master’s
PhD
Prefer not to say
How many years of work experience do you have? (This includes all types of full or part time work)
*
I have no work experience
Less than 1 year
1-3 years
3-5 years
5-7 years
7-10 years
Over 10 years
Prefer not to say
Which of the following demographics do you identify with? Select all that apply.
*
Indigenous
Black
Person of colour
White
My demographic is not listed here
Prefer not to say
Which Indigenous group do you identify with? Select all that apply (This is a self-identification question, you do not need to have Indian Status or be recognized by the government)
*
First Nation
Métis
Inuit
My Indigenous identity is not listed here
Prefer not to say
Do you identify as a person living with a disability? (This is a self-identification question, you do not need to have an official diagnosis.)
*
Yes
No
Unsure
Prefer not to say
Consent
*
I agree with the Privacy & Consent Statement
Thank you for participating in this online survey to assess the reach of our activities. IYR will share the results of this survey in a highly aggregated report (no unique identification) to our program funder.
Your participation in this survey is voluntary. You may refuse to take part in this survey, skip questions or exit the survey at any time without penalty.
You will receive no benefits from participating in this online survey, but your responses will help us improve the program. There are no foreseeable risks involved in participating in this online survey..
If you feel you have not been treated according to the descriptions in this statement, or that your rights as a an evaluation participant have not been honored during the course of this program, or you have any questions, concerns, or complaints that you wish to address, please contact IYR’s Privacy Officer James Arruda at james@indigenousyouthroots.ca.
You may print a copy of this consent for your records. Clicking on the “Agree” button indicates that: You have read the above statement; You voluntarily agree to participate.
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