APTN Insiders Panel
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Signup Questionnaire

Please complete the short questionnaire. You must complete all questions to proceed to registration.

1. Do you self identify as an Aboriginal or Indigenous person?*
2. If yes, which of the following groups, if any, do you identify with? Select all that apply.*

3. Which gender do you identify most with?*
4. Please select the month and year in which you born*
5. In which Province or territory do you reside? Please select one response.*
6. Are you employed in any of the following industries?*
7. Who is your television provider in home? Please select one response only.*

8. How often do you watch Aboriginal Peoples Television Network (APTN)? Please select one response only.*
9. How did you hear about APTN Insiders?