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• Last name *
• Birth date * (Ex: 1987-12-29)
• Home phone number *
• Cell phone number
• Street address * Apt. 
• City *
• Province * Alberta British Columbia Prince Edward Island Manitoba New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Newfoundland and Labrador Northwest Territories Yukon
• Postal code *
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• Gender * FemaleMale
• Citizenship * CanadianPermanent resident
• I am an aboriginal * No Inuit Métis First Nations
• I am a member of a visible minority * No Arab West Asian Other Chinese Korean Japanese Latin American Multiple visible minority Black Filipino South Asian South East Asian

• Canada World Youth is committed to equity in recruitment and diversity. We welcome applications from aboriginal youth, visible and ethnic minorities, persons with disabilities, persons of minority sexual orientations and gender identities, and others who may contribute to nurture the diversity of our volunteer teams.

• I want my name to be added to Canada World Youth's mailing lists
• How did you first hear about Canada World Youth? * Friend/family member Teacher/guidance counsellor Presentation by a past participant of Canada World Youth Canada World Youth program in your community Poster/promotional brochure of Canada World Youth Television Newspaper/magazine Radio Web site of Canada World Youth Other Web sites (specify below) Youth, travel, education, or job fair (specify below) Other (specify)
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