Application Form for Appointment or Nomination to Board or Committees

"*" indicates required fields

Name / ᐊᑏᑦ*

Gender / ᑭᓲᓃᑦ

Are you over 18? / 18ᓂᑦ ᐊᕐᕌᒍᖃᖅᐱᑦ ᐅᖓᑖᓂᓘᓐᓃᑦ?*

Yes/ᐄ

No/ᐋᒡᒐ:

Enrolled under Nunavut Agreement? / ᓄᓇᕗᒻᒧᑦ ᐊᖏᖃᑎᒌᒍᑎᒥᒃ ᐃᓚᒋᔭᐅᓂᕐᒧᑦ ᑎᑎᕋᖃᓯᐅᔾᔭᐅᓯᒪᕖᑦ?*

Yes / ᐄ

No / ᐋᒡᒐ

Permanent Residence / ᑐᕌᕈᑏᑦ ᓇᔪᒐᕆᔭᑦ

Street Address / ᐊᖅᑯᑏᑦ*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Address / ᑎᑎᕋᕐᕕᐅᑉ ᑐᕌᕈᑎᖓ*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Info / ᑐᓴᕆᐊᕐᕕᐅᔪᒪᒍᕕᑦ ᓇᓗᓇᐃᕆᐊᓖᑦ

Phone # (Home) / ᐆᖄᓚᐅᑏᑦ # (ᐊᖏᕐᕋᒥ)*

Phone # (Work) / ᐅᖄᓚᐅᑏᑦ # (ᓴᓇᕕᖕᓂ)

Cell Phone # / ᐅᖄᓚᐅᑎᕋᓛᑦ #*

Email / ᐃᕐᖐᓐᓈᖅᑕᐅᑏᑦ

Name(s) of Board or Committee: / ᑲᑎᒪᔩᑦ ᑲᑎᒪᔨᕋᓛᓪᓘᓐᓃᑦ ᐊᑎᖓ:*

If multiple: which board/committee are you most interested in? / ᐊᑕᐅᓯᐅᖏᑉᐸᑦ: ᓇᓕᐊᒃ ᑲᑎᒪᔨᐅᕕᒃ/ᑲᑎᒪᔨᕋᓛᖑᕝᕕᒃ ᐃᓚᐅᕕᒋᔪᒪᒐᕕᐅᒃ?

What is your knowledge of the Board/Committee that you are applying for? / ᑲᑎᒪᔨᐅᕕᒃ/ᑲᑎᒪᔨᕋᓛᖃᕐᕕᒃ ᖃᓄᖅ ᖃᐅᔨᒪᓂᖃᕐᕕᒋᕕᐅᑉ ᐃᓚᐅᕝᕕᒋᔪᒪᔭᑦ?*

Why are you interested in the Board(s)/Committee(s) that you are applying for? / ᖃᓄᐃᒻᒪᑦ ᑲᑎᒪᔨᐅᕕᒃ/ᑲᑎᒪᔨᕋᓛᖃᕐᕕᒃ ᐃᓚᐅᕝᕕᒋᔪᒪᕕᐅᒃ?*

What experience do you have in advancing or advocating for Inuit rights? / ᑭᓱᓂᒃ ᑭᒡᒐᖅᑐᐃᔨᐅᖃᑕᐅᓯᒪᕕᑦ ᑭᒡᒐᖅᑐᐃᔪᒪᔾᔪᑎᒋᕕᐅᒡᓘᓐᓃᑦ ᐃᓄᐃᑦ ᐱᔪᓐᓇᐅᑎᖏᓐᓃᒃ?*

What relevant work experience do you have? / ᑭᓱᓂᒃ ᐱᓕᕆᓯᒪᕕᑦ ᑕᒪᑐᒧᖓ ᐊᒃᑐᐊᓂᖃᖅᑐᓂᒃ?*

What education or training do you have? / ᐃᓕᓐᓂᐊᖅᓯᒪᓂᖃᖅᐲᑦ ᐱᓕᒻᒪᒃᓴᖅᑕᐅᓯᒪᕕᓪᓘᓐᓃᑦ?*

Other relevant experience or qualification / ᑭᓱᓂᒃ ᑕᒪᑐᒪᖓ ᐃᑲᔪᕈᓐᓇᖅᑐᓂᒃ ᐱᓕᕆᓯᒪᕕᒃ ᐊᔪᖏᑦᑕᖃᖅᐱᓪᓘᓐᓃᑦ?

Some Board applications require Criminal Records Checks, please be prepared to provide one if requested. / ᐃᓚᖏᑦ ᑲᑎᒪᔨᙳᕈᑎᒃᓴᑦ ᐱᕋᔭᒃᓯᒪᖏᒃᑲᓗᐊᕐᒪᖔᖅᐱᑦ ᖃᐅᔨᓴᖅᑕᐅᓯᒪᔭᕆᐊᖃᕐᒪᑕ, ᓂᕆᐅᖕᓂᐊᖅᐳᑎᑦ ᑐᓂᓯᖁᔭᐅᑐᐃᓐᓇᕆᐊᖃᕐᓂᕐᒧᑦ ᑐᒃᓯᕋᕐᕕᐅᒍᕕᑦ.

4534