Toronto-Rankin Inlet Exchange
Organized by Canadian Roots Exchange
Youth Application Form
Who Are We?
We are Canadian Roots Exchange (CRE), a group of Indigenous and non-Indigenous youth who believe in a Canada where youth stand in solidarity to promote respect, understanding and reconciliation between Indigenous and non-Indigenous peoples. We believe that having dialogue is necessary to foster understanding and reconciliation. Central to CRE programming is the need to bring together Indigenous and non-Indigenous youth through national exchange opportunities.


The Rankin Inlet Exchange

Canadian Roots Exchange is recruiting Indigenous and non-Indigenous Youth from the Greater Toronto Area to participate in the Rankin Inlet Exchange.

From February 22nd-28th 2017, Toronto will host the Rankin Inlet participants for six days and participate in group activities, sightseeing and events. The Toronto team will then travel to Rankin Inlet from April12th-17th for the second phase of the exchange.

Youth between the ages of 14 and 17 years of age are encouraged to apply. Youth must have two valid pieces of ID to participate (Travel Stipulations)

Fundraising as a team will be a crucial part of preparing for this exchange so that each individual participant is not responsible for fees.

Questions? Contact us:
Info@canadianroots.ca
647-956-5019

Full Name
Your answer
Pronouns (i.e. she, they, ze, him)
Your answer
Email
Your answer
Telephone
Your answer
Birthday
MM
/
DD
/
YYYY
Sex
Your answer
Are you currently a high school student?
Name of school
Your answer
Address
Your answer
City/Town/Community
Your answer
Province
Your answer
Postal Code
Your answer
Canadian Roots Exchange is actively committed to ensuring that we are reaching the diversity of Canada’s population. We track this information to ensure that we remain accessible to diverse communities of youth.
Do you identify as an Indigenous person?
Please specify Nation/Community:
Your answer
I am a member of a “visible minority” (ex. an individual other than an Indigenous person, who is non-Caucasian) CRE encourages you to self identify
Please specify "visible minority" community:
Your answer
Do you currently have two pieces of valid photo ID?
Would you be able to commit to helping with fundraising efforts?
Please list three reasons why you would like to participate in a Canadian Roots Exchange program:
Your answer
What are you hoping to learn by participating in a Canadian Roots Exchange program?
Your answer
Describe any activities, hobbies or interests that are most important to you.
Your answer
Do you require any accommodations for accessibility and mobility needs? (Ex, wheelchair accessibility)
Your answer
Do you have any dietary restrictions?
Your answer
Do you have any allergies or health-related conditions that we should be aware of?
Your answer
Please list any additional information you would like to share and any special considerations that organizers may require.
Your answer
How did you find out about the exchange? (Please check all that apply)
Contact Information of Parent/Guardian (Name, Relationship, Phone Number)
Your answer
If you have any problems submitting this form please email us at info@canadianroots.ca. For additional information please visit www.canadianroots.ca and please "like" our Facebook page.
Wela'lin! Thank You!
Submit
Never submit passwords through Google Forms.
This form was created inside of Canadian Roots Exchange. Report Abuse - Terms of Service - Additional Terms