Indigenous Youth Advocacy Week (Sept 2023) – Application Form Step 1 of 2 50% DemographicsWhat is your full name?* What is your email address?* Enter Email Confirm Email Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code What is your phone number?*Have you ever participated in a CRE program, activity, or event before?*YesNoUnsurePrefer not to sayIf you have, how many times?*OnceTwiceThree times or moreUnsurePrefer not to sayPlease enter your current postal code (e.g. A1B2C3):* Which of the following best describes where you currently live?*UrbanRuralRemoteOn-reservePrefer not to sayWhich 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)* 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?*YesNoUnsurePrefer not to sayHow old will you be when the program starts? Please enter the number representing your ageWhich 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 CertificateCollege CertificateCollege DiplomaBachelor’sMaster’sPhDPrefer not to sayHow many years of work experience do you have? (This includes all types of full or part time work)*I have no work experienceLess than 1 year1-3 years3-5 years5-7 years7-10 yearsOver 10 yearsPrefer not to sayWhich 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.)*YesNoUnsurePrefer not to say Program questionsPlease 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!*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?*What topics would you most like to discuss with a Minister, Member of Parliament, and/or Senator? Please pick 3 from the list below. If your topic is not in the list, select "Other" to include a topic.* Landback, Self-Governance and/or Reconciliation (including treaty rights, law and justice reform) The Climate Crisis Health Care (including mental health care and sexual health care) 2SLGBTQ+ Rights & Issues Disability Rights & Issues Education Housing Employment Other What other topics would you most like to discuss with a Minister, Member of Parliament, and/or Senator? Have you ever taken part in lobby or advocacy weeks such as this before? This will not impact your application, rather will help us understand how to best prepare participants for success!*Please confirm that you are available for the proposed dates listed in the program description and summarized here: Only those that are available will be considered for acceptance to the program.Capacity Building Sessions: Wednesday evenings (6:00-8:00PM EST) between 25/10/2023-15/11/2023 (4 sessions total)* Yes, I am available No, I am not available Advocacy Week: Various times (in 30-45 minutes slots) primarily between 20/11/2023-30/11/2023.* Yes, I am available No, I am not available You will be attending at least 2-3 meetings each between the hours of 11:00-5:00PM EST throughout those dates. Calendar invites will be sent as soon as they are confirmed. *If any meetings must fall outside of those times, we will let you know in advance. Closing Engagement: Wednesday December 6th in the evening (EST).* Yes, I am available No, I am not available Consent* I agree with the Privacy & Consent StatementThank you for participating in this online survey to assess the reach of our activities. CRE 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 CRE’s Privacy Officer James Arruda at james@canadianroots.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.CAPTCHA Δ