Educator, Schools & Group - Legacy Schools Registration Form

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Educator, Schools & Group - Legacy Schools Registration Form

First Name

Last Name

Please confirm your email address

Phone (please include area code)

Signing up as a

Name of school board / district:

Name of school:

Department / Office: (optional)

Only required if your Toolkit needs to be delivered to a specific department or office within a building
Example: "English Department", "Library"

Address Line 1

Address Line 2

City

Province / Territory

Postal code

School grades

Total number of students participating

Number of classrooms participating

Name of club/group

Name of branch/unit of club or group

Department / Office: (optional)

Only required if your Toolkit needs to be delivered to a specific department or office within a building
Example: "English Department", "Library"

Website of Club

Address Line 1

Address Line 2

City

Province/Territory

Postal code

Age levels of branch/unit

Total number of youth participating

Number of groups participating

Would you like your toolkit shipped to a different address? If yes, please enter the mailing address below

YesNo

Address Line 1

Address Line 2

City

Province/Territory

Postal code

Job title

Toolkit language preference

EnglishFrench (please note some materials may be in English due to availability)

I already received a toolkit this year to the above registered school

YesNo

How did you hear about the Legacy Schools program?

Please explain if other:

Referral information

Friend's first name

Friend's last name

Friend's email address

Is your school, club, or group Indigenous-led, Indigenous-serving, or located in an Indigenous Nation, community or territory?

YesNoUnsure/ Prefer not to sayOtherThis may include schools or groups that are:
• Led by Indigenous staff, Elders, or Knowledge Keepers
• Primarily serving Indigenous students or families
• Located in or affiliated with First Nations, Inuit or Métis
• Offering Indigenous-focused programming or partnerships

The following questions are designed to let us know where you are on your learning journey when it comes to reconciliation. We are here to help and support you on that journey. There are no wrong answers.

	Strongly disagree	Disagree	Agree	Strongly agree
As a club leader/educator, I understand how to teach about Indigenous ways of knowing, culture, and perspective.
In my opinion, staff in my school/club feel empowered to teach about current issues facing Indigenous communities.
As an educator/leader, I am comfortable teaching about residential schools.

Please provide any other relevant information.

Yes, sign me up for the newsletter (PO BOX 749 Ohsweken ON, N0A 1M0). Subscribing is a great way to access additional learning opportunities, such as ways to celebrate and teach about upcoming Indigenous dates of significance, DWF LIVE sessions, contests, community events, and more! You can unsubscribe at any time. 

You agree that the Gord Downie & Chanie Wenjack Fund (DWF) may collect, use, and disclose the personal data you provide in this form to provide mandatory program communications. DWF requires that you receive certain emails, including educator surveys, to participate in the Legacy Schools program. All data will be handled in accordance with our Privacy Policy.