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FIRST DIRECTIONS 2024: INDIGENIZED LOVE
20%
1.
What
name
can we use for you?
(Required.)
2.
What
pronouns
can we use for you?
e.g. (he/him/his) (she/her/hers) (they/them/theirs) (ze/hir/hirs) (per/per/pers)
3.
How can we reach you?
(Required.)
Email Address
*
Phone Number
4.
Do you identify as Indigenous, Inuit, Métis, or First Nations?
(Required.)
Yes
No
5.
Do you primarily live in what is now called British Columbia?
Yes
No
6.
What is your home address?
Name
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
7.
If possible, please share your
nation(s), community(ies),
or
band(s)
. It's ok if we do not know the answer to this question.
8.
Are you between 15 and 29 years old?
(Required.)
Yes
No
9.
When is your birthday?
Month/Day/Year
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
10.
Are you available to participate in the following First Directions program dates?
Tuesday, March 12, 2024 - Sunday, March 17, 2024
Yes
No
11.
If you are under the age of 18, do you have permission from your caregiver, parent, guardian, or social worker to participate in this program?
Yes
No
Not yet - I would like help to talk to this person.
I am 18 years old, or older, and do not need permission from a caregiver, parent, guardian, or social worker to participate.
