Declaration of Indigenous Ancestry or Affiliation
To ensure PAFNW’s programs reach eligible Indigenous People, we require proof of Indigenous ancestry or affiliation. It is also understood that due to colonialism, some individuals will not be able to obtain the required proof. Please respond as best you can to the following questions:
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Preferred method of contact
*
Email
Phone
Are you an Indigenous Person?
*
Yes, First Nations (includes Status, Treaty and Band Member)
Yes, First Nations (Non-Status - Not registered under the Indian Act)
Yes, Inuit (Status)
Yes, Inuit (Non-Status)
Yes, Metis (Status)
Yes, Metis (Non-Status)
No, not an Indigenous person
Are your biological parents Indigenous?
*
Yes, Mother and Father
Yes, Mother only
Yes, Father only
Other
Are you aware of what Indigenous nation (i.e. Cree, Ojibway) you are descended from?
*
Yes
No
If yes to above, please specify
Please provide an explanation of the circumstances of why you are unable to obtain proof of your Indigenous ancestry or affiliation.
I hereby declare that all information given above is complete and true to the best of my knowledge.
*
Yes
Submit
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