1. Continent:

  2. Name:

  3. Mailing Address:

  4. Telephone:

  5. E-mail:

  6. Country and Region:

  7. Indigenous Nation:

  8. Indigenous Peoples Organization or community you are connected with:

  9. Website of your organization:

  10. Why do you want to get involved and how would you be able to support this project?

  11. What is your first language?

    Can you speak, read, and/or write it fluently?

  12. Do you speak any other language(s)?

    Do you read and/or write these languages fluently?

  13. When can you submit a personal narrative (personal biography)?

  14. When can you submit a picture of yourself?

  15. Can you organize film/music material from your peoples?
    (Please view all points in our video outline)

    a) From your peoples


    b) Your environment, including wildlife


    c) Traditional/contemporary music


    d) Issues or problems


    e) Community projects/alternatives/solutions    


    Description of material:

  16. Which topics of our Video Project (Please view our Outline) could you best advise on?
    (do you have a theme/interest/knowledge, i.e. women's issues, farming, biodiversity, water, political issues, environment, the UN system, youth, health etc., etc)


Thank you!