Knowledge Keeper & Elder Request Form

Please Read Before Submitting

Knowledge Keeper and Elder requests follow a three step process:

1.) Complete and submit the form below at least two weeks before the event date for consideration (requests are not guaranteed).

2.) An Indigenous Initiatives staff member will follow up with more details regarding your request. If your request is approved, you will be asked to complete step 3.

3.) Read our Guidelines for Respectful Engagement with Knowledge Keepers & Elders. These guidelines must be followed to ensure cultural protocols are adhered to and that Knowledge Keepers and Elders are treated with respect.

Requester Contact Information

Requester Name*

First Last

Email*

Phone*

Event Details

Event Title*

Date of Event*

Start Time of Event*

What time does the event start?

:

End Time of Event*

What time does the event end?

:

Requested Arrival Time*

:

Event Location Name*

Event Location Address*

Street Address City

Specific Location to Meet

Please indicate if there is a specific location to meet (e.g. front entrance).

Event Description*

Please be specific in what your expectations are for the Knowledge Keeper/Elder.

Information For Knowledge Keeper/Elder

Knowledge Keeper/Elder Duties*

Are there certain activities or protocols that you would like the Knowledge Keeper/Elder to facilitate?

Length of Knowledge Keeper/Elder Address*

What is the allotted time for the Knowledge Keeper/Elder to speak?

:

Please Indicate Whether the Knowledge Keeper/Elder Is Invited to Stay Following Their Scheduled Presentation or Activity*

Invited to stay
Participation concludes following their contribution

Request a Specific Knowledge Keeper/Elder*

Do you have a specific Knowledge Keeper/Elder you would like us to request? If not, we will ask who we feel is appropriate for your event.

Joan Church
Susie McPherson Derendy
No preference

Expected Number of Attendees*

On-Site Contact Person/Helper*

The point person who will be greeting and supporting the Knowledge Keeper/Elder during your event.

First Last

On-Site Contact/Helper Phone*

This will be a number we can reach you at during your event or for the Knowledge Keepers/Elders to connect for support or questions. Cell preferred.

In-Person Requests

To ensure the comfort and safety of Knowledge Keepers/Elders while attending in-person events, we are asking that event organizers coordinate and cover the cost of transportation to and from the event, as well as provide refreshments.

Are you able to coordinate and cover the costs of transportation for the Knowledge Keeper/Elder to travel to and from the event?*

Yes
No
Not applicable

Are you able to coordinate and cover the costs of refreshments for the Knowledge Keeper/Elder attending the event?*

Yes
No
Not applicable

Honorarium

Please connect with the Director of IPC, Alison DuBois, to discuss the honorarium portion of your request.

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Brandon University