Current Page 1 Page 2 Preview Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act as it relates directly to the administration of this program and will be used for determining program eligibility and maintaining program data. If you have any questions about this collection of personal information, you may call 902-838-0662. Identification First Name Middle Initial Last Name Address 1 Address 2 City, Town, or Community Province Postal Code For example C1B 0X1 or 12345 Country Telephone Number For example 902-555-5555 Email Address Date of Birth What is your first language? - Select -EnglishFrenchOther Other Language Are you proficient in other languages? - Select -YesNo Other Languages What grade will you be enrolled in as of September 2023? - Select -9101112 Diversity and Inclusion Data Collection: The Department is committed to diversity and inclusion and ensuring the Youth-on-Board Project is representative of our Island's diverse community. This information will help us to assess how well we are achieving our diversity and inclusion goals to be an inclusive organization and help us better address the diverse needs of our community. We have taken all steps to ensure that your responses are completely confidential and will only be used for statistical and diversity analysis purposes. While completion of the following questions is completely voluntary, we strongly encourage you to take the time to respond to this section. Do you identify yourself as a person with a disability? - Select -YesNoI choose not to disclose Do you identify as a member of Indigenous Peoples? - Select -YesNoI choose not to disclose Do you identify as part of another under-represented group? - Select -YesNoI choose not to disclose Do you identify as a member of the Acadian or Francophone community? - Select -YesNoI choose not to disclose Do you identify as 2SLGBTQIA+? - Select -YesNoI choose not to disclose Do you identify as: - Select -MaleFemaleGender Not ListedPrefer Not To Say