Indigenous Membership Form Full Name(Required) Preferred Pronoun(s) He, She, His, Hers, They, Them, Theirs, Ze, Sie, Zie, HirAddress(Required) Street Address City State / Province / Region ZIP / Postal Code Email(Required) Phone (VRS, Text, TTY or Voice) Example: (613) 519-2944 (Text or Voice)Self-Identification – I declare that I am:(Required) First Nations Status Metis Inuit Other Eligibility – I agree with the following: I am above 18 years of age I have legal status in Canada I am Deaf, Deaf-Blind, or Hard of Hearing I can communicate fluently in ASL or LSQ and/or ISL Terms I read and acknowledge my benefits as an indigenous member. By applying for indigenous membership, I acknowledge and fully understand that the CAD-ASC Board may revoke my membership should it deem my actions, comments and/or behaviour not align with CAD-ASC’s mission, vision, or goals. I understand that the membership is free for life, and that I must contact CAD-ASC directly if I wish to cancel it for any reason. I am aware that indigenous membership does not grant authorization to vote, as per CAD-ASC bylaws. I have a proof of status to be shown or discussed with the National Indigenous Director, and I will send it to admin@cad-asc.ca HiddenMake a Donation $25 $50 $75 $100 $250 $500 Other Tax receipt is issued for $10 or more.Total Anything Else?Anything else you want to tell us?Would you like to make a donation? You can do so on our Make a One-Time Donation page.