Contact & Registration Form- Gide'inaan Language & Culture Division of LCO

Intake

Contact Information

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1. What is your full name? (Required.)

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2. What is your Ojibwe/Indian/Spirit name? (Required.)

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3. Who is your clan/doodem? (Required.)

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4. What is your tribal affiliation? (Required.)

LCO member

LCO descendant

LCO member spouse

LCO community member (non-Native)

Bad River member or descendant

Red Cliff member or descendant

St. Croix member of descendant

Lac du Flambeau member or descendant

Mole Lake member or descendant

Other Ojibwe member or descendant

Other tribe member or descendant

Non-native

Other (please specify)

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5. What community do you live in? (Required.)

DryTown, Round Lake, Barbertown, Watertower

Bacon Square, Bacon Strip, Poppletown

Schoolhouse, Akikaandag, Mandaamin

Giiwedin, Ishkwaandem, Miskogiizhig

K-Town, Tall Pines

New Post, Blueberry, Six-Mile

Boulevard, Grindstone

Skunawong, Gurno Lake, Reserve

Whitefish, Billy Boy, Signor

Black Bear, Chief Lake

Hayward

Other (please specify)

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6. What is your email address? (Required.)

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7. What is your contact number? (Required.)

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8. What is your address? (Required.)

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9. What is your preferred method of contact? (Required.)

Phone call

Text

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10. How did you hear about us?

Facebook, Social Media

Flyers in the community

Friends, Word of mouth

Tribal website

Other (please specify)

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11. What size t-shirt do you wear? (Required.)

Adult Small

Adult Medium

Adult Large

Adult XL

Adult XXL

Adult XXXL

Adult 4XL

Youth Small

Youth Medium

Youth Large

Youth XL

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12. How would you describe your language ability? (Required.)

I have no prior knowledge of the Ojibwe language.

I know a few words.

I can understand a little.

I can speak the basics, smalltalk.

I am conversational.

I am a proficient/fluent speaker.

I am a first-language speaker (elder).

Other (please specify)

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13. What are your primary goals for learning Ojibwe? (Required.)

I want to use it daily with friends, family and elders.

I want to connect better to spirituality and ceremony.

I want professional development for my own work or teaching job.

I want personal enrichment and cultural identity.

I want to be a better ally and community member.

All of the above.

Other (please specify)

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14. What is your preferred learning environment? (Required.)

One on One mentorship

Individual, self-paced (online)

Classroom, group settings

Camp style, activity based

Other (please specify)

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15. Are there specific cultural practices that you wish to learn? (Required.)

Asemaa, ceremonies, and traditional spiritual practices

Season harvests (ricing, hunting, ice-fishing, sugarbush, spearing, etc.)

Traditional foods and cooking

Regalia making (beading, sewing, etc.)

Traditional medicines (plant identification)

Clan system, history, storytelling

Drum singing, drum making

All of the above

Other (please specify)

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16. Do you need any accommodations to fully participate in Gide'inaan activities? (Required.)

Visual/hearing

Transportation assistance

Childcare/Elder care

Other (please specify)

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17. What days and times work best for you to participate? (Required.)

Weekday daytime

Weekday evenings

Weekend daytime

Weekend evenings

Other (please specify)

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18. By signing below, you agree to Gide'inaan storing your information for internal program use only. You also consent to photography and video recording at Gide'inaan programs and events. By signing you also agree to treat all Gide'inaan staff, participants, programs and teachings with respect and integrity. Print your name in the comment box showing your consent. (Required.)

Contact & Registration Form- Gide'inaan Language & Culture Division of LCO

Intake

Question Title

* 1. What is your full name? (Required.)

Question Title

* 2. What is your Ojibwe/Indian/Spirit name? (Required.)

Question Title

* 3. Who is your clan/doodem? (Required.)

Question Title

* 4. What is your tribal affiliation? (Required.)

Question Title

* 5. What community do you live in? (Required.)

Question Title

* 6. What is your email address? (Required.)

Question Title

* 7. What is your contact number? (Required.)

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* 8. What is your address? (Required.)

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* 9. What is your preferred method of contact? (Required.)

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* 10. How did you hear about us?

Question Title

* 11. What size t-shirt do you wear? (Required.)

Question Title

* 12. How would you describe your language ability? (Required.)

Question Title

* 13. What are your primary goals for learning Ojibwe? (Required.)

Question Title

* 14. What is your preferred learning environment? (Required.)

Question Title

* 15. Are there specific cultural practices that you wish to learn? (Required.)

Question Title

* 16. Do you need any accommodations to fully participate in Gide'inaan activities? (Required.)

Question Title

* 17. What days and times work best for you to participate? (Required.)

Question Title

1. What is your full name? (Required.)

2. What is your Ojibwe/Indian/Spirit name? (Required.)

3. Who is your clan/doodem? (Required.)

4. What is your tribal affiliation? (Required.)

5. What community do you live in? (Required.)

6. What is your email address? (Required.)

7. What is your contact number? (Required.)

8. What is your address? (Required.)

9. What is your preferred method of contact? (Required.)

10. How did you hear about us?

11. What size t-shirt do you wear? (Required.)

12. How would you describe your language ability? (Required.)

13. What are your primary goals for learning Ojibwe? (Required.)

14. What is your preferred learning environment? (Required.)

15. Are there specific cultural practices that you wish to learn? (Required.)

16. Do you need any accommodations to fully participate in Gide'inaan activities? (Required.)

17. What days and times work best for you to participate? (Required.)