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Online Registration Form
Ahkamimohwin - Anti-Racism and Decolonization Workshop
Date: March 6-8, 2023. Location: Brandon Friendship Centre, Brandon, MB
Space is limited. You will receive an email upon confirmation of registration.
First Name:
*
Last Name:
*
Age Group:
*
12-17 yrs
18-29 yrs
30-49 yrs
50-69 yrs
70+
Gender
*
Female
Male
2SLGBTQQIA+
Status:
*
First Nations
Metis
Inuit
Non-Status
Non-Indigenous
Address:
*
City/ Town/ Community:
*
Province:
*
Manitoba
Postal Code:
*
Phone Number
*
Email Address:
*
Facebook Name:
Is there any special accommodations including diet restrictions our Team needs to be aware of to ensure you can participate?
Which of the following applies to you?
*
Family member of a MMIWG
Survivor of Gender-Based Violence
If you selected family member of MMIWG, please indicate name of loved one:
Indicate if the following applies to you: (Optional)
Indian Residential School Survivor
Indian Day School Survivor
Do you require travel accomodations?
*
Yes
No
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