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Indigenous Youth Advocacy Week 2024 – Application Form
Indigenous Youth Advocacy Week 2024 – Application Form
2024-08-13T11:15:11-04:00
Questionnaire below
About you
What is your full name?
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What is your email address?
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Enter Email
Confirm Email
What is your mailing address?
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Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Have you ever participated in a IYR program, activity, or event before?
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Yes
No
Unsure
Prefer not to say
If you have, how many times?
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Once
Twice
Three times or more
Unsure
Prefer not to say
Please enter your current postal code (e.g. A1B2C3):
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Which of the following best describes where you currently live?
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Urban
Rural
Remote
On-reserve
Prefer not to say
Which of the following genders do you identify with? Select all that apply (Cisgender or cis refers to a person who identifies with the gender they were assigned at birth)
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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?
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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.
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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?
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Elementary (Grade 6)
Middle School (Grade 9)
High School (Grade 12)
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)
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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.
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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)
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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.)
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Yes
No
Unsure
Prefer not to say
Program Questions
Please tell us a little bit about yourself! You can include information about your connection to community as an Indigenous person, your goals (personally or professionally) or anything else you think might help us get to know you a bit better!
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Why do you want to be a part of this advocacy week? Why do you believe it is important for Indigenous youth to be involved in policy through advocacy?
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Have you ever taken part in lobby or advocacy opportunities such as this before? This will not impact your application, rather will help us understand how to best prepare participants for success!
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What does self-determination make you think of?
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What would you want to bring up to a politician about self-determination?
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Program Availability
It’s important that you can attend all the program dates to ensure your success. Please confirm that you are available for all program dates:
Capacity Building Sessions: Wednesday evenings (6:00-8:00PM ET) between 09/10/2024-30/10/2024 (4 sessions total)
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Yes, I am available
No, I am not available
Advocacy Week meetings: Various times between 05/11/2024-14/11/2024. Meetings will be 30-45 minutes each, and times will be provided to you in advance.
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Yes, I am available
No, I am not available
Closing Engagement: Wednesday November 20 (6:00-8:00PM ET)
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Yes, I am available
No, I am not available
Consent
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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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