Indigenous Community Based Masters Application Form

Email

This field is for validation purposes and should be left unchanged.

Registration Form

Please fill out all required fields and the privacy declaration at the end of this form. Upon completion and submission of your application, a confirmation email will be sent to the email you provided. If you have questions about the form or program, please contact (877) 488-6888.

Personal Information

Last (Family) Name*

First (Given) Name*

Middle Name(s)

Preferred Name (if different from First Name)

Social Insurance number*

Health Services Number*

Physical Address (Street, Box or Apartment Number)*

Please fill out both physical and mailing addresses.

City/Town*

Province*

Postal Code*

Country*

Mailing Address (Street, Box or Apartment Number)*

City/Town*

Province*

Postal Code*

Country*

Home Phone (include area code)*

Cell Phone (include area code)

Date of Birth*

Email Address*

Indigenous Ancestry & Affirmation

Please provide your Métis Nation Saskatchewan (MN-S) Citizenship number or check applicable box below.

Ancestry*

Registered Métis (MN-S) Citizenship Number

Alternate/Emergency Contact

This person will be contacted if we cannot reach you by way of your contact information, or in the vase of an emergency.

First (Given) Name*

Last (Family) Name*

Mailing Address (Street, Box or Apartment Number)*

City/Town*

Province*

Postal Code*

Home Phone (include area code)*

Cell Phone (include area code)

Declaration

The privacy of your information is important to us. Personal information that you provide to the Gabriel Dumont Institute may be shared with Gabriel Dumont Institute Training and Employment for the purpose of planning, education, and employment-related assistance. If you do not wish to share your information, please contact the Student Registration Department at 306-242-6070.

By selecting I Agree below, I acknowledge my consent to GDI’s use and disclosure of my personal information as outlined above.
I hereby certify that all the information on this form is true and complete.

I Agree

Indigenous Community Based Masters Application Form

Registration Form

Personal Information

Indigenous Ancestry & Affirmation

Alternate/Emergency Contact

Declaration

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