FEEWI Eligibility

Your privacy is our priority. All information provided in this survey will remain confidential and will be used solely to improve our services and programs to better serve you.

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* 1. Name

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* 2. At what email address would you like to be contacted?

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* 3. Do you self-identify as Black? (African Canadian, Black, Afro-Caribbean, Afro-Latino, Afro-Indigenous, African American, or mixed-race of African descent)

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* 4. Do you self-identify as a Black person with disabilities, or a Black parent, partner, caregiver, and/or guardian of a Black child, adult, or senior with disabilities?

In Canada, a disability is defined under the Accessible Canada Act as any physical, mental, intellectual, cognitive, learning, communication, or sensory impairment—or functional limitation—that, in interaction with a barrier, hinders a person's complete and equal participation in society. It includes permanent, temporary, or episodic conditions, whether evident or not.)

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* 5. Do you self-identify as a person with a disability? (Diagnosed, Undiagnosed, or Self Diagnosed)

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* 6. Are you a Black person, parent(s), partner(s), caregiver(s), and/or guardian(s) of Black children, adult(s), or senior(s) with disabilities? (Diagnosed, Undiagnosed, or Self Diagnosed)

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* 7. To help confirm eligibility for benefits and tax-related supports, please confirm your are a Canadian Citizen, Permanent resident, Refugee claimant or protected person, Temporary resident of 18 months or more (eg. work or study permit)

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