Urban Butterflies Application Form
This application form is end-to-end encrypted. Urban Butterflies is a group for Indigenous children and youth in foster care ages 7 to 14 that meet one Sunday a month from 2:30 pm to 4:30 pm.Giving children and youth a greater awareness of how to prevent risk factors and improve health outcomes of young First Nations/Metis/Inuit youth. Providing unique and fun opportunities to work and learn cultural art and dance, learn about their spirituality and gain skills to survive emotional pain associated with living in foster care away from their family. Creating a setting where they can learn skills to be self- reliant and know where to go for help and support, the older girls from the Mentor Me group provide a much needed support system to do many community activities and cultural projects to enhance their lives together and to plan their futures. The Urban Butterflies program was founded by Joy Chalmers (1953-2021)
Child's Name
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First Name
Last Name
Child's pronouns/Gender identity
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Indigeneity: Child's Nation and Community (i.e. Dakelh-Carrier from Cheslatta, Squamish from Capilano, etc. We understand this information is not always known, please share as much detail as possible. This information is used to personalize teachings and shared with our Language department so that we may scout for Indigenous language teachers to share teachings for each child.)
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Child's Date of Birth
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Month
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Day
Year
Date
Child's Allergies
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Please provide the name and contact information (with permission) of the person that we should notify when we have a workshop/event and want to invite the child to take part, as well as their relationship to the child.
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What is your name and relationship to the Child? Please include your contact information.
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Is the child in foster care? (If in temporary care, or respite care, please select "Yes")
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Yes
No
I don't know
Are you able to share some of the interests of the child, including their favourite sports/activity, favourite food, favourite book, favourite animal, favourite colour? We try our best to personalize birthday gifts for the children and will use this information to form future programming for the Urban Butterflies program.
Submit
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