KaPeKiwehtahat Pre-Screen

KaPeKiwehtahat Pre-Screen - New Item

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The Ka-pe-kiwehtahat Housing Support Team supports Indigenous people at risk of homelessness to assess existing housing challenges and risk factors, provide available resources, create a plan for housing security, and build strategies to prevent homelessness in the future.

Full Name *

Date of Birth *

Phone Number *

Email *

How did you hear about the Ka-pe-kiwehtahat Housing Program? *

Are you connected with any other programs at Miskanawah? *

None

Strengthening Home Fires

Nitsanak Mamawintowak

Tawaw Family Resource Network

Miywasin Nohkom

Diamond Willow Youth Lodge

Healing Lodge

Other (describe below)

Other Miskanawah Program

Do you identify as Indigenous? *

Yes

Do you live in Calgary and surrounding area? *

Yes

Have you received financial support from Miskanawah's housing program in the past 12 months? *

Yes

Are you currently living in shelter? *

Yes

Do you have a lease in your name? *

Yes

What expense are you seeking financial support for? *

Amount of support needed *

When is this support needed by *

What is your total monthly income? *

What is your source of income? (select all that apply) *

Source of income - Other

Miskanawah is rooted in cultural ceremonies and practices and prides itself in sharing Indigenous ways of knowing, being and doing with the greater community.

Guided by the concept of Wahkotiwin (Cree for ‘living in relationship’), we strive to build a strong and resilient community of care by inviting our circle of relatives to join us in Indigenous traditions, ceremony and celebration (eg. sharing circles, sweat lodges, pipe ceremonies, connecting with Elders, medicine picking, drum making, etc.).

Are you interested in receiving information from our Cultural Team about ongoing cultural opportunities and connections, regardless of whether you qualify for financial support at this time? *

Yes

By signing this form, I consent to have Miskanawah staff collect my personal information for the purpose of assessing my eligibility for housing supports.

Type Your Initials Here to Acknowledge Consent

⚠ There are items in this form that require your attention