Consent for release of personal information to Indigenous Services Canada

Complete this form by October 7th for your chance to win one of five food hampers valued at $350

Without your help, YFNED may lose its Jordan's Principle funding to offer the programs that are making a difference for our kids. In order to meet Indigenous Services Canada’s updated funding requirements, we need to collect information about all Indigenous kids who access our services.

Your information is safe and will only be shared with Indigenous Services Canada for Jordan’s Principle applications.

Child/Youth Information

First name *

Last name *

Date of birth *

First Nation *

Status/Citizenship Number * If they do not have their own, enter a parent or grandparent’s number.

Name associated with number Leave blank if the number belongs to the child/youth.

School *

Grade * If your child is not yet in school enter 0

Parent/Guardian Info

First name *

Last name *

Email *

Mobile

Parent/Guardian Signature

I authorize the Yukon First Nation Education Directorate to provide the above information to Indigenous Services Canada.

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Parent/Guardian Signature Signature pad

Has your child accessed services from YFNED in the past? We would love to hear about your experience.

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