Youth Ambassador Form

About You  
First Name:
Last Name:
Address:
City:
Province:
Postal Code:
E-mail:
Phone:
How old are you?
 
Education
What is your highest level of education?
 
Volunteer Experience
Please list your volunteer experiences:
References
Please provide us 3 professional or personal references. This could be teachers, professors, volunteer coordinators, work managers, family members or friends.
Reference #1
Name:
Relationship to you:
E-mail:
Phone:
Reference #2
Name:
Relationship to you:
E-mail:
Phone:
Reference #3
Name:
Relationship to you:
E-mail:
Phone:
Question
What is it about the MB 150 Youth Ambassador Program that makes you feel it is the right opportunity for you?:
What artistic medium are you thinking you would be using?
Please select all that apply.
Invitation to Voluntarily Self-Identify
Embracing diversity and inclusion for Manitoba 150 Youth Ambassador Program is our core value. We are committed to providing equal opportunity for all qualified candidates, regardless of gender, gender identity or expression, sexual orientation, age, disability, visible minority, newcomer to Canada or Indigenous/Aboriginal status. The Manitoba 150 Youth Ambassador Program is also committed to creating an inclusive environment, taking every measure to ensure that participants have access to the resources and opportunities needed to partake in the program.

If you choose not to respond to one or more questions, it will not impact your application.
1. Do you consider yourself to be an Aboriginal/Indigenous Person? For employment purposes, “Aboriginal Peoples” are indigenous peoples (i.e. the original peoples of a region) of Canada who identify themselves to be First Nations, Inuit or Métis.
 
2. Do you consider yourself to a member of a visible minority? Under the employment Equity Act and Regulations, "members of visible minorities" are persons, other than Aboriginal Peoples, who are non-Caucasian in race or non-white in colour.
 
3. Do you consider yourself to be a person with a Disability? For employment equity purposes, "person with disabilities" are persons who have a long-term or recurring, persistent conditions, wither visible and/or invisible.
 
4. Do you consider yourself to be a member of the lesbian, gay, bisexual, transgender plus (LGBT+) community?
 
5. I identify my gender as: