• How did you hear about the IAYI Program? * Friend/family member Twitter Internet search (Google, etc.) Media (TV, Radio, Newspaper) Community Organization Past participant of a program Recruitment Consultant Social Media (specify below) Indigenous Organization (specify below) Web site of Canada World Youth Other Web sites (specify below) Other (specify)
• Specify *
• First name *
• Last name *
• Birth date * (Ex: 1987-12-29)
• Phone number *
• E-mail *
• Please re-enter your e-mail address *
• Province * Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
• Other Province
• Gender * FemaleMaleOtherNot Specified
  
• Specify if desired
• Citizenship * CanadianPermanent resident
• Do you identify as being of Indigenous ancestry * YesNo
• I identify as:

  (you can select more than one)

• First Nation (specify name)
•   On reserveOff reserve
• Metis (specify name)
•   In communityOff community
• Inuit (specify name)
•   In communityOff community

• Language Skills *

  English	None Fair Good Excellent
  French	None Fair Good Excellent
  Spanish	None Fair Good Excellent
  Indigenous Languages
  1.	None Fair Good Excellent
  2.	None Fair Good Excellent

• Are you currently attending school?* not studying
  studying full-time
  studying part-time
• If currently studying, specify Name of Institution and Academic Program

• Have you participated in another youth leadership or exchange program? International Aboriginal Youth Internship Initiative or International Youth Internship
  Canada World Youth
  Katimavik
  Youth Challenge International
  Canadian Crossroads International
  CUSO International
  Me to We
  University Exchange Program
  Québec Sans Frontières
  Northern Youth Abroad
  SWAP
  Other
•   If IAYI or IYI, please specify the year and the Canadian organisation

• Do you have a valid passport? (must be valid 6 months after the completion of your program)? * YesNo
• Are there any special support systems that you feel you will need in order to be successful on the program? *

• Canada World Youth is committed to equity in recruitment and diversity. We welcome applications from persons with disabilities, persons of any sexual orientations and gender identities , and others who may contribute to nurture the diversity of our volunteer teams.

• I want my name to be added to Canada World Youth's mailing lists
•  

• Declaration

  By checking the box below and submitting the application form, I (name of applicant), certify that all the information provided on this application form is true, correct and free from misstatement or false statement. I consent to Canada World Youth collecting this information and acknowledge that the information may be used for determining my eligibility for my application to the program and subsequent program evaluation and monitoring purposes.

  I am aware that this information is collected and administered in accordance with the CWY Privacy Policy and adheres to all relevant privacy laws.

• I agree *

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