Personal Details

Name

{{CrmPFController.contactDetails.fullname}}

School Name

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Grade

{{CrmPFController.HsGrade}}

Date of Birth (dd/mm/yyyy)

{{CrmPFController.DOB}}

Youth Email

{{CrmPFController.contactDetails.emailaddress1}}

Phone Number

{{CrmPFController.contactDetails.mobilephone}}

Citizenship Status

{{CrmPFController.Citizenship}}

Primary Spoken Language

{{CrmPFController.PrimarySpokenLang}}

Other Language

{{CrmPFController.contactDetails.av_primaryspokenlanguageother}}

Address Details

Address

{{CrmPFController.contactDetails.address1_line1}}

Suite No.

{{CrmPFController.contactDetails.av_address1suiteno}}

City

{{CrmPFController.contactDetails.address1_city}}

Province

{{CrmPFController.contactDetails.address1_stateorprovince}}

Postal Code

{{CrmPFController.contactDetails.address1_postalcode}}

Country

{{CrmPFController.contactDetails.address1_country}}

CWF Wild Outside Location

Which WILD Outside location are you applying for?

{{CrmPFController.Region}}

Which WILD Outside location are you applying for?

Other

Other

{{CrmPFController.contactDetails.av_otherregion}}

Self-Identification

Preferred Name/Nickname

{{CrmPFController.contactDetails.av_preferrednamenicknameother}}

Age

{{CrmPFController.contactDetails.av_age}}

Highest Level of Education

{{CrmPFController.Highestlevelofeducation}}

Home

{{CrmPFController.contactDetails.cr6cc_phonehome}}

Gender

{{CrmPFController.Gender}}

My pronouns are

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I self-identify as

{{CrmPFController.Iselfidentify}}

Parent/Guardian Details

Parent/Guardian Name

{{CrmPFController.contactDetails.av_parentguardianname}}

Parent/Guardian Email

{{CrmPFController.contactDetails.av_parentguardianemail}}

1) Why do you want to get involved in WILD Outside?

{{CrmPFController.contactDetails.av_whydoyouwanttogetinvolvedinwildoutside}}

2) What conservation topics most interest you?

{{CrmPFController.contactDetails.av_whatconservationtopicsmostinterestyou}}

3) How did you hear about the program?

{{CrmPFController.hearAboutus}}

Other

{{CrmPFController.hearAboutusOther}}