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Indigenous Health Coalition Application

Thank you for your interest in joining the Indigenous Health Coalition. Filling out this application does not guarantee a position on the coalition, and applicants will be notified if they have been offered an opportunity for a trial membership position. 
1.What is your first & last name?(Required.)
2.Members of this coalition must be Indigenous. What is your affiliation with the Native community?(Required.)
3.Tell us about how your lived experience as an Indigenous person might inform the work of the coalition.(Required.)
4.What is your age?(Required.)
5.Tell us a little about yourself (e.g. education, community work, work history):(Required.)
6.Why are you interested in joining the coalition?(Required.)
7.How do you currently contribute to your Indigenous community?(Required.)
8.Which sector(s) do you consider yourself a representative of, both personally and/or professionally? Check all that apply.(Required.)
9.What particular skillset(s) would you bring to the coalition, professionally and/or personally? Check all that apply.(Required.)
10.What Traditional skillsets do you have (e.g. beading, subsistence lifestyles, fishing, language teacher)?(Required.)
11.Which Tribal Nation has the best fry bread, and why?(Required.)
CONTACT INFO
12.Email address:(Required.)
13.Phone:(Required.)
14.Address (street, city, state, zip code)(Required.)
15.Where do you live?(Required.)
16.How did you hear about this opportunity?(Required.)
17.If you are not selected to join the coalition, would you still be willing to/interested in engaging in our efforts in other ways as new opportunities arise?