Technodigenous

Basic Information

Please provide us with some information about yourself. For questions 6-14, please answer in a few sentences.

Please complete this survey no later than September 6th, 2019 to be considered.

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* 1. Name

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* 2. Tribal Affiliation

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* 3. Where do you live?

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* 4. Where do you work?

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* 5. Email Address

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* 6. Telephone Number

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* 7. Social media handle (s)

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* 8. Address

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

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* 9. What are your areas of expertise?

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* 10. What motivates you in your current field of expertise?

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* 11. How would you describe to your neighbor what you do?

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* 12. What do you enjoy doing recreationally?

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* 13. Please share your experience working cross-culturally and with Indigenous Peoples?

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* 14. How did you hear about Technodigenous?

Nia Tero staff

Nia Tero partners

MIT Media Lab

Other (please specify)

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* 15. Why are you interested in Technodigenous?

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* 16. What do you hope to contribute to Technodigenous?

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* 17. What do you hope to learn from Technodigenous?

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* 18. Will you need financial support to attend Technodigenous? Our grant covers travel for the guest speakers, Indigenous contributors and artists.

Transportation

Accommodation

Meals

Travel documents

Other (please specify)