Naskapi Nation Communications Survey

Please read before you begin.

Your answers help the Nation reach you the way you prefer, and help us keep our band records up to date. Everything you share here is kept confidential. Only Nation staff working on communications and band records can see it. We will never sell it or share it outside the Nation. Filling this out enters you in a prize draw. You can skip any question that is not marked required.

Consent(Required)

I have read this and I agree to take part.

Are you filling this out for someone else?(Required)

No, this is for me

Yes, I am filling it out for another person

First, tell us about yourself.

Your full name(Required)

Your band number(Required)

Your birthday(Required)

Your relationship to the person(Required)

For example parent, child, caregiver.

Confirmation(Required)

The person named below knows I am filling this out for them, or I am their guardian or caregiver.

Now, the details of the person this survey is about. Enter their information below.

Full name(Required)

Band number(Required)

Used to make sure each person is only entered once.

Birthday(Required)

Used only to sort entries into the Elder, Adult, and Youth prize groups.

Phone number

Which house do they live in?(Required)

Who lives in the household?

List the people in the household.