INDIGENOUS PARENT LEADERSHIP
TRAINING INITIATIVE

APPLICATION FORM

Thank you for your interest in the Indigenous Parent Leadership Training Initiative! Please complete the information below and submit. An Indigenous Visioning Representative will be contacting you to schedule an interview.

*We are currently accepting applications in White Earth for fall 2022

Name

First Name

Last Name

Tribal affiliation

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age

Home phone

(###)

###

####

Phone

(###)

###

####

How would you prefer to be contacted?

Are you a

Number of children

Ages of children

Will you need child care?

Schools attending (if school age)

What issues concern you for your children and other children in your Tribal Nation?

What skills would you like to learn to become a strong parent leader for your Tribal Nation?

Are you able to commit your time to attend the retreat and all 20 class sessions?

What might be some barriers to your attendance?

How did you hear about us?

INDIGENOUS PARENT LEADERSHIP TRAINING INITIATIVE

INDIGENOUS VISIONING, LLC

INDIGENOUS PARENT LEADERSHIP
TRAINING INITIATIVE

INDIGENOUS
VISIONING, LLC