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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.)

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

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10. Do you have any dietary restrictions? Please specify. (Required.)

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11. What size t-shirt do you wear?

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

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

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

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

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

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

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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.)

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