Member Information

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* Name

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* Date of Birth

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* Status Number

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* Please enter your contact information

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* Do you live on Kapawe'no First Nation Reserve?

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* Preferred method of communication

If you are a parent/guardian of a Kapawe'no First Nation member under the age of 18 and they are living with you, please complete the following section.

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* Are you a parent/guardian of Kapawe'no First Nation members under the age of 18 and they are living with you? 

 
33% of survey complete.

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