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ICAN Intake Form
Contact Preferences
Preferred method of contact
Phone
Email
Text message
Video call
Do you want to join the ICAN Facebook Chat? If yes, please tell us your Facebook profile name.
Eligibility
Do you identify as a person with an intellectual disability, including neurodivergence?
Yes
No
Are you 18 years or older?
Yes
No
How did you learn about the ICAN program?
INSK staff
ICAN member
INSK webside
Social media
Participation Goals
These questions help us to know what ICAN members might be interested in taking part in. Saying you might be interested does not mean you have to take part or that there are options to join at this time.
What are your current top priorities?
Social connection
Building self-advocacy skills (educational)
Virtual events
In-person events
Daytime events
Evening events
Are you interested in taking part in committees or project work with Inclusion Sasktchewan Staff?
Yes
No
Are you interested in doing presentations with Inclusion Saskatchewan staff?
Yes
No
Virtual
In-person
Are there topics you want to learn about through ICAN?
Are there any social or recreational activities you would like to see as part of ICAN?
Contact Preferences
Preferred method of contact
Do you want to join the ICAN Facebook Chat? If yes, please tell us your Facebook profile name.
Eligibility
Do you identify as a person with an intellectual disability, including neurodivergence?
Are you 18 years or older?
How did you learn about the ICAN program?
Participation Goals
What are your current top priorities?
Are you interested in taking part in committees or project work with Inclusion Sasktchewan Staff?
Are you interested in doing presentations with Inclusion Saskatchewan staff?
Are there topics you want to learn about through ICAN?
Are there any social or recreational activities you would like to see as part of ICAN?
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