* Legal first name

Legal middle name

* Legal last name

Pronouns

Other name

Preferred name

* Address

Address 2

* City/Town/Reserve

* Province/Territory

* Postal code

* Primary email

Secondary email

* Primary phone

Work phone

Mobile phone

Fax number

Check all that apply

I am a professional artist

I am an Indigenous Knowledge Keeper

I am an Arts/Cultural professional

I am an educator

* Check all disciplines that are applicable to you as an assessor

Craft genres

Dance genres

Literary arts genres

Media genres

Music genres

Theatre genres

Visual arts genres

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Part II Voluntary identification

The Manitoba Arts Council is committed to supporting artistic practices that reflect the diversity of Manitoba's population. You are invited to complete the voluntary identification portion of this profile registration. This is entirely optional. This information will be used to monitor how well MAC grants reflect the full diversity of who we are as a province. For further information, please read MAC's policy on the use of personal information.

What is your primary language?

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Do you speak, read and/or understand the following:

English

Check all options that apply

Speak

Read

Understand

French

Check all options that apply

Speak

Read

Understand

Other

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Check all options that apply

Speak

Read

Understand

Birth year

Gender

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Do you identify as any of the following:

Indigenous

Select all options that apply to you

First Nations

Metis

Inuit

Other

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What is the Indigenous community that you belong to?

Francophone

Select all options that apply to you

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Black and/or a Person of Colour

Select all options that apply to you

Black

Person of Colour

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Deaf

Please select 'Yes' if you are D/deaf, deafened or hard of hearing.

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Living with a disability (including physical, psychiatric, and intellectual disabilities)

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2SLGBTQ+

Please select this option if you identify as Two-Spirit, lesbian, gay, bisexual, transgender, queer, or part of the 2SLGBTQ+ community in any other way.

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Part of any other underserved community

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If you would like MAC to take into account the information you share in this section when putting together assessment panels (so that you can help assess applications where your background and insights might be especially valuable), we ask you to give us permission for that by checking the box marked 'I agree' below. You may withdraw your permission whenever you want by unchecking that same box.

The information I provide in this section may be used by MAC when considering me for membership in upcoming assessment panels

Agree

* Information acknowledgement

I hereby declare that the information in this profile is correct to the best of my knowledge and I undertake to update my profile on a timely basis with any changes to this information.

* Terms and conditions

MAC's Terms and Conditions of Access.

I have read MAC's policy on using this online application system and I agree to these terms and conditions.

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