Winnipeg's Indigenous Accord Online Application

	Personal Information
Name of your organization or group *
Address *
City *
Province *
Postal Code *
Contact Name *
Contact Email Address *
Confirm Contact Email Address *
Contact Phone Number *	XXX-XXX-XXXX


Verification Code *
	* indicates required field. Your IP address will be logged as 172.26.123.212.

PRIVACY AND CONSENT

Any personal information collected is done so under the authority of s.36(1)(b) of The Freedom of Information and Protection of Privacy Act. This information will be used to administer Winnipeg’s Indigenous Accord program and will not be used or disclosed for any other purposes, except as authorized by law. If you have any questions about the collection of this information, contact the Corporate FIPPA Coordinator by mail to City Clerk’s Department, Administration Building, 510 Main Street, Winnipeg MB, R3B 1B9, or by telephone at 311.

	Questionnaire
Does your group or organization have an Indigenous governance structure?*	Yes
	If Yes, please specify: First Nation Metis Inuit Includes all Indigenous groups
	No
	If No, does your group or organization have one or more of the following (select all that apply): Yes, we have an Indigenous Council Yes, we have an Indigenous division or department Yes, we have an Indigenous strategy Yes, we have relationship(s) or partnership(s) with Indigenous communities Yes, other: No, none of the above

Were you previously, or are you currently, involved in work related to the Truth and Reconciliation Commission’s 94 Calls to Action?*	Yes If Yes, please identify the Call(s) to Action number(s) (# / #’s): No

Have you identified what you would like to do to meet the Truth and Reconciliation Commission’s 94 Calls to Action as a partner to Winnipeg’s Indigenous Accord?*	Yes If Yes, please identify the Call(s) to Action number(s) (# / #’s): Not yet, but we are well on our way to identify what we would like to do. Not yet We would like your assistance by providing the following information to us:

Were you previously, or are you currently, involved in work related to the Missing and Murdered Indigenous Women and Girls (MMIWG) Calls for Justice?*	Yes If Yes, please identify the Call(s) for Justice number(s) (# / #’s): No

Have you identified what you would like to do to meet the MMIWG Calls for Justice as a partner to Winnipeg’s Indigenous Accord?*	Yes If Yes, please identify the Call(s) for Justice number(s) (# / #’s): Not yet, but we are well on our way to identify what we would like to do. Not yet We would like your assistance by providing the following information to us: