Individual - Japanese Canadian Legacies Fund

User Registration Form (Individual)

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Account Type(Required)

Individual

Username(Required)

Enter a username that will be used when logging in. This cannot be changed.

Password(Required)

Enter Password Confirm Password

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Contact Information

Name(Required)

First Middle Last

E-mail Address(Required)

Enter Email Confirm Email

Phone Number(Required)

Alternate Phone Number

Website

Social Media Address

Address(Required)

Street Address Address Line 2 City Province Postal Code

Identity

Do you identify as Japanese Canadian?(Required)

Yes

Are you a Descendant?(Required)

Yes

Are you a Survivor?(Required)

Yes

In 300 words or less, describe your personal connection to the Japanese Canadian community. If applicable, describe the background of your family’s experience in Canada prior to and including 1942.(Required)

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