Donation Forms - Nistawoyou Association Friendship Centre

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Donation form

by nistawoyou1 | Dec 13, 2017

Membership Form

NAFC Membership Form

Primary Contact Name (Please complete all contact fields) *

Primary Contact Name (Please complete all contact fields)

First

Last

Phone *

Email *

Preferred Contact Method *

Call

Text

Email

Date of Birth (mm/dd/yyyy) *

Preferred Pronouns

He/Him

She/Her

They/Them

Do you self identify as an Indigenous person? (Primary Contact)

If yes, please identify (as many as applicable)

First Nation

Inuit

Metis

Other

If you have selected "Other", please specify.

Spouse/Secondary Contact Name (Please complete all contact fields)

First

Last

Secondary Contact Phone

Seondary Contact Email

Preferred Contact Method (Secondary Contact)

Call

Text

Email

Do you self identify as an Indigenous person? (Secondary Contact)

If yes, please identify (as many as applicable)

First Nation

Inuit

Metis

Other

If you have selected "Other", please specify.

Mailing Address (Street Number, Name) *

City *

Province *

Postal Code *

Physical Address, if different than above (Street Number, Name)

City

Province

Postal Code

Do you have children/grandchildren? (If yes, please provide the following information) *

Yes

No

Children/Grandchildren Name (Under 18)

First

Last

Date of Birth (mm/dd/yyyy)

Preferred Pronouns

He/Him

She/Her

They/Them

Does your child/grandchild self identify as an Indigenous person?

If yes, please identify (as many as applicable)

First Nation

Inuit

Metis

Other

If you have selected "Other", please specify.

Children/Grandchildren Name (Under 18)

First

Last

Date of Birth (mm/dd/yyyy)

Preferred Pronouns

He/Him

She/Her

They/Them

Does your child/grandchild self identify as an Indigenous person?

If yes, please identify (as many as applicable)

First Nation

Inuit

Metis

Other

If you have selected "Other", please specify.

Children/Grandchildren Name (Under 18)

First

Last

Date of Birth (mm/dd/yyyy)

Preferred Pronouns

He/Him

She/Her

They/Them

Does your child/grandchild self identify as an Indigenous person?

If yes, please identify (as many as applicable)

First Nation

Inuit

Metis

Other

If you have selected "Other", please specify.

Children/Grandchildren Name (Under 18)

First

Last

Date of Birth (mm/dd/yyyy)

Preferred Pronouns

He/Him

She/Her

They/Them

Does your child/grandchild self identify as an Indigenous person?

If yes, please identify (as many as applicable)

First Nation

Inuit

Metis

Other

If you have selected "Other", please specify.

Would you like to be contacted if we have a program or service that may interest you? *

Yes

No

If you are at the Centre or participating in a program we offer, do you approve of us sharing you photo? *

Yes

No

Would you like to be added to our list of volunteers? (If yes, an NAFC Team Member will be in touch with you with further information) *

Yes

No

Please let us know if there are any services you think we should offer that are not currently not available through our organization.

How did you hear about us? (Please check all that apply)

Already a member

Family or friends

Facebook

Instagram

Other

If you have selected "Other", please specify.

Number

If you are human, leave this field blank.

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