You can complete the application on your own device by downloading the form below. Submit the completed PDF via email to: intake@kanachihih.ca.

Provide as much information as possible, and if there are any questions that are Not Applicable (N/A) or Unknown (UNK), please indicate so.

 

Intake Form

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Centralized Referral Form
Please check off which healing lodge you are applying for:

Part 1 - Application

A. Personal Information