2020 Northern Youth in Service Application

1

Your Name* This field is required.

First Name

Last Name

2

Email

example@example.com

3

Home Phone Number* This field is required.or the best number to reach you at. You can put a family members phone if you do not have one.

Area Code

Phone Number

4

Cell Phone Number

Area Code

Phone Number

6

Home Community * This field is required.

7

Gender* This field is required.

Female

Male

Other

8

Date of Birth* This field is required.

Date

9

Are you Indigenous?* This field is required.

Inuit

First Nation

Métis

Non-Indigenous

10

Why do you want to participate in this program?* This field is required.(explain why you want to learn how to organize a community-based project)

13

Do you have a project idea or interest area? If so, please tell us all about it. You can also say here if you would want to do a group project or work with other youth. * This field is required.If you know who you would like to work with, please share their names. Each Participant will need to fill out this form, even if you are working together. To fill out another application, you can click again on the application link.

14

Describe your community. What is it like to live in your community? What makes it great? What can you do to help make it better?* This field is required.Please give as much detail as possible. Don't worry too much about spelling or grammar, this is not formal. We want to hear what YOU think.

15

Tell us about any ways that have been involved in your community.* This field is required.(for example: helping at events, babysitting, participating in other programs, volunteering)

16

Education* This field is required.

I am a high school student

I have graduated high school

I am in college/university/training

I have graduated from college/university

17

What grade are you in?

18

What is the name of your program? What is the name of your school?

19

What year of college/university are you in?

20

Employment* This field is required.

I am working part-time

I am working full-time

I am currently looking for work

I am not looking for work right now

21

Do you have access to the internet and a device (computer or phone)?* This field is required.If you only have access from the school or in specific situation, please choose "other" and write more information

Yes, always

Yes, sometimes

Rarely

Never/ not right now

22

Are you willing to dedicate at least 2 hours a week to participating in this program?* This field is required.Throughout the next year, participants will have to commit at least two hours a week (either completing assignments, planning their projects, delivering their projects or volunteering in their communities). When answering this question, think about your school, work and family commitments.

YESNO

23

Is there anything else you'd like to tell us?

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