Indigenous SCI Gathering - Vancouver Registration

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* 1. How do you identify?

Indigenous

Metis

Inuit

Other (please specify)

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* 2. Are you living with an SCI?

Yes

No

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* 3. If you answered 'No", please indicate your relationship with an individual living with an SCI?

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* 4. Please provide the following information, so that Praxis can follow-up with you directly

Your Full Name

Your e-mail address

The city in which you reside

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* 5. Are you interested in attending the first Indigenous SCI Gathering in Vancouver, BC on Friday, November 4th?

Yes

No

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* 6. How would you be travelling to the event? Will you require assistance covering the costs of this travel?