Teacher Candidate - Legacy Schools Registration Form

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Teacher Candidate - Legacy Schools Registration Form

First name

Last name

Personal Email

Please confirm your email address

Phone (please include area code)

Name of Department

Name of University or College

Home Address for Toolkit Shipment

Mailing address

City

Province/Territory

Postal code

Toolkit language preference

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

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.

How did you hear about the Legacy Schools program?

Practicum Placement Information

We require this information to understand the reach and impact of the Toolkit we send to you. If practicum placement is unknown, please provide most recent practicum information, or provide your teachable subjects and grade level you will be responsible for.

School Grades at Practicum

I already received a toolkit

YesNo

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.