Section 1: Background Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1. Please indicate what position(s) are you interested in? *Deputy LeaderPresidentGeneral SecretaryTreasurerCommunications Officer / PR & Social Media RepPolicy and Research OfficerMembership and Outreach OfficerLegal and Compliance OfficerEvents and Campaigns CoordinatorYouth and Student Affairs OfficerWomen’s Affairs OfficerParliamentary Representatives ( Must be Dominican Citizen )2. What is your full name? *FirstLast3. What name do you prefer to go by? *4. Email *5. How old are you? *18 – 25 years26 – 35 years36 – 45 years46 – 55 years56 – 65 years66 years and up6. Are you male or female? *MaleFemale7. Where were you born? *DominicaCanadaUnited States of AmericaThe United KingdomOther8. If you were born in Dominica, which city or village did you live in immediately after birth?Anse du MéAtkinsonBagatelleBatakaBellesBellevue ChopinBenseBiocheBoeticaBornesCalibishieCampbellCanefieldCapucinCastle BruceCliftonColihautCottageCoulibistrieDelicesDublancDubucEgglestonFond CaniFond St. JeanGalionGiraudelGood HopeGoodwillGrandbayGrand FondLa PlaineLaudatLayouLoubiereMadrelleMahautMarigotMassacreMeroMorne DanielMorne ProsperPaix BouchePenvillePetite SavannePetite SoufrierePichelinPointe MichelPortsmouthRosalieRoseauSaint JosephSalisburySalybiaSan SauveurScotts HeadSoufrièreStockfarmStoweTanetaneTarouThibaudToucariTrafalgarVieille CaseWarnerWesleyWoodford HillWotten WavenOther9. Where do you currently live? *Anse du MéAtkinsonBagatelleBatakaBellesBellevue ChopinBenseBiocheBoeticaBornesCalibishieCampbellCanefieldCapucinCastle BruceCliftonColihautCottageCoulibistrieDelicesDublancDubucEgglestonFond CaniFond St. JeanGalionGiraudelGood HopeGoodwillGrandbayGrand FondLa PlaineLaudatLayouLoubiereMadrelleMahautMarigotMassacreMeroMorne DanielMorne ProsperPaix BouchePenvillePetite SavannePetite SoufrierePichelinPointe MichelPortsmouthRosalieRoseauSaint JosephSalisburySalybiaSan SauveurScotts HeadSoufrièreStockfarmStoweTanetaneTarouThibaudToucariTrafalgarVieille CaseWarnerWesleyWoodford HillWotten WavenOther10. Do you identify as a member of the Kalinago community? *YesNo11. Do you currently live in the Kalinago Territory? *YesNo12. Is Dominica your primary place of residence since December 19, 2024? *Under 1 year1 – 3 years4 – 5 years6 – 10 years10 – 20 yearsOver 20 years13. Do you rent or own your home? *OwnRent14. Who do you live with? *Spouse/PartnerParent(s)Friend(s)/Family15. Do you have children? *None12345 or more16. Are you currently employed? *YesNo17. If yes, what is your occupation? which you live 18. Do you own a vehicle or do you use public transit? *YesNo19. Do you own a boat? *YesNo20. Have you ever lived abroad? *YesNo21. If yes, for how long?Under 1 year1 – 3 years4 – 5 years6 – 10 years10 – 20 yearsOver 20 years22. What country (ies)?CanadaThe United States of AmericaThe United KingdomOther23. How would your friends describe your personality? *24. How would you describe your personality? *25. What are your hobbies or interests? *26. What’s your favorite holiday or celebration? *27. What’s your favorite way to spend a weekend? *28. Would you prefer to go to the: *BeachRiverWalk/HikeVisit Friends and FamilyRestaurant29. What’s your favorite movie or TV show? *30. Do you enjoy ________ sports? *PlayingWatchingNeither31. Please tell us what sports?32. If you could meet any famous person (alive or dead), who would it be? *33. Do you vote in national elections? *YesNo34. Did you vote in the last national election? *YesNoContinue to Section 2: Community Background
