2020 Northern Youth in Service Application

1
Your Name* This field is required.
First Name
Last Name
2
Email
example@example.com
3
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
Other Phone Number
Area Code
Phone Number
5
What is the best way to get a hold of you?* This field is required.
Home Phone
Facebook
Cell Phone
Email
Text me
6
Home Community * This field is required.
7
Address
PO Box
Street Address Line 1 (if applicable)
Community
Territory
Postal Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Gender* This field is required.
Female
Male
Other
9
Date of Birth* This field is required.
Date
Year
Month
Day
10
Are you Indigenous?* This field is required.
Inuit
First Nation
Métis
Non-Indigenous
11
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)
Huge
Large
Normal
Small
Ok
Ok
12
What types of projects are you interested in?* This field is required.Choose your top 3
Traditional Skills (sewing, hunting, Inuktitut revitalization)
Music (organizing music lessons, starting a band/choir, organize a small concert)
Art (organizing arts/crafts workshops, organizing beading workshops)
Carpentry (building/crafting things for the community)
Environment (community clean ups, recycling programs)
Recreation (sports activities, fitness groups)
Elder Engagement (organizing activities for elders, collecting stories)
Youth Engagement (starting a youth committee)
Philanthropy (clothing/food drives, starting a food bank)
Cooking/culinary (organizing cooking workshops, creating a local cookbook)
13
Rate yourself for each of these items* This field is required.Remember: this is just to give us an idea of how we can best help you learn through our program, so try to answer as honestly as possible. There are no right or wrong answers!
Not at all
Not really
Somewhat
A little bit
Yes, definitely
I know what a community-based project is.
I know what I want to do for my community-based project.
I know people in my community who can help me with my project.
I know what a community-based project is.
I know what I want to do for my community-based project.
I know people in my community who can help me with my project.
Not at all
Not really
Somewhat
A little bit
Yes, definitely
Not at all
Not really
Somewhat
A little bit
Yes, definitely
Not at all
Not really
Somewhat
A little bit
Yes, definitely
1 of 3
14
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.
Huge
Large
Normal
Small
Ok
Ok
15
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.
Huge
Large
Normal
Small
Ok
Ok
16
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)
Huge
Large
Normal
Small
Ok
Ok
17
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
I have not graduated, and I am not in school
18
If you are in school, what grade/year are you in?
19
What is the name of your program? What is the name of your school?
20
What year of college/university are you in?
21
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
22
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
23
Are you willing to dedicate at least 2 hours a week to participate 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
24
Is there anything else you'd like to tell us?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty:

Save your progress

Save your progress

Your form submission has been saved as a draft.

Save your progress

Your form submission has been saved as a draft.