QUESTIONAIRE

1. Continent:
   

   Africa
   Asia
   Australia
   Europe
   North America
   Central America
   South America
   



2. Name:
   
   


3. Mailing Address:
   
   


4. Telephone:
   
   


5. E-mail:
   
   


6. Country and Region:
   
   


7. Indigenous Nation:
   
   


8. Indigenous Peoples Organization or community you are connected with:
   
   


9. Website of your organization:
   
   


10. Why do you want to get involved and how would you be able to support this project?
    


11. What is your first language?
    
    Can you speak, read, and/or write it fluently?
    


12. Do you speak any other language(s)?
    
    Do you read and/or write these languages fluently?
    
    


13. When can you submit a personal narrative (personal biography)?
    
    


14. When can you submit a picture of yourself?
    
    


15. Can you organize film/music material from your peoples?
    (Please view all points in our video outline)
    
    

    a) From your peoples	Yes    No
    b) Your environment, including wildlife	Yes    No
    c) Traditional/contemporary music	Yes    No
    d) Issues or problems	Yes    No
    e) Community projects/alternatives/solutions	Yes    No

    
    Description of material:
    


16. Which topics of our Video Project (Please view our Outline) could you best advise on?
    (do you have a theme/interest/knowledge, i.e. women's issues, farming, biodiversity, water, political issues, environment, the UN system, youth, health etc., etc)
    

Thank you!