Status of Women Council of the NWT
Status of Women Council of the NWT

Coalition Against Family Violence (CAFV)

Membership Application Form


Please note that where ever there is a * that field is required to fill out before you can submit the form. 

*
Contact Information *
Contact Information
Address
Address
Office Phone
Office Phone
Home/Cellphone
Home/Cellphone
Signing Up As (Please Check Only One) *
Please note that while you may have perspectives that are valuable to discussion from many other positions you hold. You can only represent the organisation/department or yourself that you choose on this form. Please feel free to add to the discussion but if voting occurs you can only vote once for whom you represent on this form.
This section is for members representing an organisation or government department. I will be representing the below organisation/department while I am at CAFV meetings.
If you are a board member or officially affiliated with any other organisations please state them below.
*
Chooe one
This section is for members representing themselves. I am aware that I can speak about my experiences and concerns but that I cannot speak on behalf of my employer or any organisation/department I am involved with. My employer is aware that I am on the CAFV and they are listed below.
If you are a board member or officially affiliated with any other organisations please state them below.
Level of Commitment *
please choose what level of involvement you would like to have within the CAFV. Active Member: members that you would attend at minimum 6 monthly meetings a year, respond to emails within given timelines at minimum 80% of the time, expected to participate in at least one working group, attend at least one event per year, have voting rights and receive information emails. Regular Members: would receive information emails but have no voting rights. Please note that if you are an active member who is unable to meet the commitments listed you will become a regular member until you are able to meet those commitments. I would like to be a(n)
Specialization
My main areas of concern or interest are (please check all that apply)
Consent
You will be contacted by the number or email you have provided to confirm that you would like to be on the Coalition Against Family Violence. If you have any other concerns or would like this form in a different format please contact the Status of Women Council of the NWT.