Nunavut Harvest Support Program / ᓄᓇᕗᒻᒥ ᐊᖑᓇᓱᒃᑎᓄᑦ ᐃᑲᔫᑎᒃᓴᑦ

Nunavut Harvester Support Program

"*" indicates required fields

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The NHSP Harvesting Equipment Program provides Inuit in Nunavut who are in need with funding assistance to make harvesting equipment and tools more affordable so they can participate in traditional harvesting activities. / NHSP ᐊᖑᓇᓲᑎᓂᒃ ᐱᖁᑎᓂᒃ ᐃᑲᔫᑎ ᐃᓄᖕᓄᑦ ᓄᓇᕗᒻᒥ ᐃᑲᔪᖅᑕᐅᒋᐊᓕᓐᓄᑦ ᑮᓇᐅᔭᑎᒍᑦ ᐃᑲᔫᑎᓄᑦ ᐊᖑᓇᓲᑏᑦ ᐱᖁᑏᑦ ᓱᓇᒃᑯᑖᓪᓗ ᐅᓇᒻᒥᓇᕐᓂᕐᓴᐅᖁᓪᓗᒋᑦ ᓂᐅᕕᐊᕆᓗᒋᑦ ᐊᖑᓇᓱᖃᑕᐅᔪᓐᓇᕈᑎᒃᓴᑦ ᐱᖅᑯᓯᒃᑯᑦ.

To read more about the program guidelines click here.

ᐅᖃᓕᒫᒃᑲᓐᓂᕈᒪᒍᕕᑦ ᐃᑲᔫᑏᑦ ᒪᓕᒐᖏᑕ ᒥᔅᓵᓅᖓᔪᓂᑦ ᓇᕿᓪᓗᒍ ᐅᓇ.

APPLICANT INFORMATION/ ᑐᒃᓯᕋᖅᑐᖅ ᓇᓗᓇᐃᒃᑯᑕᖓ

All fields with * are required / ᑎᑎᖅᓯᒪᔪᓕᒫᑦ ᐅᓪᓗᕆᐊᕐᖑᐊᓕᖕᒥ * ᑕᑕᑎᖅᑕᐅᒋᐊᖃᖅᑐᑦ

Please enter your name / ᐊᑏᑦ ᑎᑎᕋᙳᐊᑕᕐᓯᓐᓇᕈᒃ*

First Name / ᐊᑏᑦ Last Name / ᐊᑎᕈᓰᑦ

Email / ᐃᕐᖐᓈᖅᑕᐅᑖ

Phone Number / ᐅᖄᓚᐅᑖ*

NTI number / ᓄᓇᕗᑦ ᑐᙵᕕᒃᑯᓐᓂᑦ ᐃᓚᒋᔭᐅᔾᔪᑏᑦ ᓈᓴᐅᑖ*

Do not include dashes or spaces with your NTI number / ᐱᖃᓯᐅᔾᔨᑦᑕᐃᓕᒋᑦ ᑎᑎᖅᓯᒪᔪᓂᑦ ᓈᓴᐅᑎᐅᙱᑦᑐᓂᑦ ᐊᒻᒪᓗ ᑲᑎᙵᑎᑦᑕᐃᓐᓇᕆᓗᒋᑦ ᓄᓇᕗᑦ ᑐᙵᕕᒃ ᑎᒥᖓᓄᑦ ᓈᓴᐅᑎᕆᔭᑎᑦ

Date of Birth / ᐃᓅᓕᕐᕖᑦ

Day / ᐅᓪᓗᖅ*

Month / ᑕᖅᑭᖅ*

Year / ᐊᕐᕌᒍ*

Mailing Address / ᑎᑎᖅᑲᓂᐊᕐᕕᒃᑯᑦ ᑐᕌᕈᑖ

Mailing Address / ᑎᑎᖅᑲᓂᐊᕐᕕᒃᑯᑦ ᑐᕌᕈᑖ*

House number / ᐃᒡᓗᕕᑦ ᓈᓴᐅᑖ P.O Box / ᑎᑎᖅᑲᓂᐊᕐᕕᖓ Community / ᓄᓇᓕᒃ Province / ᓄᓇᓕᐅᑉ ᐊᕕᒃᑐᖅᓯᒪᓂᕆᔭᖓ Postal Code / ᑎᑎᖅᑲᓂᐊᕐᕕᒃᑯᑦ ᓇᓗᓇᐃᒃᑯᑕᖓ

PROGRAM INFORMATION /ᐃᑲᔪᖅᑕᐅᔾᔪᑕᐅᔪᓐᓇᖅᑐᑦ

PLEASE INDICATE WHICH SUBSIDY YOU ARE APPLYING FOR (You can check more than one box): / ᓇᓗᓇᐃᒃᑭᑦ ᓇᓕᖏᓐᓂᒃ ᐃᑲᔪᖅᑕᐅᔾᔪᑎᓂᒃ ᑐᒃᓯᕋᕐᒪᖔᕐᐱᑦ (ᐊᑕᐅᓯᐅᓐᖏᑦᑐᒥᒃ ᑎᑎᕐᓯᕕᖃᕈᓐᓇᖅᑐᑎᑦ):*

Small Equipment / ᐱᖁᑎᕋᓛᖅ

Safety Equipment / ᓱᓇᒃᑯᑏᑦ ᐊᑦᑕᓇᕐᔭᐃᕈᑏᑦ

Insurance Coverage for Small Equipment / ᓇᓪᓕᐅᒃᑯᒫᑦ ᒥᑭᔫᑎᓄᑦ ᐊᖑᓇᓲᑎᓄᑦ ᐱᖁᑎᓄᑦ

Insurance Coverage for Safety Equipment / ᓇᓪᓕᐅᒃᑯᒫᑦ ᐊᑦᑕᓇᐃᖅᓯᒪᓂᕐᒧᑦ ᐱᖁᑎᓄᑦ

Insurance Coverage for Large Harvesting Equipment / ᓇᓪᓕᐅᒃᑯᒫᑦ ᐊᖏᔫᑎᓄᑦ ᐊᖑᓇᓲᑎᓄᑦ ᐱᖁᑎᓄᑦ

APPLICANT ELIGIBILITY / ᑐᒃᓯᕋᕈᓐᓇᖅᑎᑕᐅᔪᑦ

ᑮᓇᐅᔭᑎᒍᑦ ᐃᑲᔫᓯᐊᕈᓐᓇᖁᓪᓗᑎᑦ, ᓇᓗᓇᐃᕆᐊᖃᖅᑐᑎᑦ: /TO RECEIVE FUNDING ASSSISTANCE, YOU HAVE TO CONFIRM:*

You are 16 years of age or older and enrolled in the Nunavut Agreement You engagement / ᐅᑭᐅᖃᕆᐊᑦᓴᕕᑦ 16-ᓂᒃ ᐅᖓᑖᓂᓘᓐᓃᑦ ᐊᒻᒪᓗ ᐊᑎᖃᖃᑕᐅᓗᑎᒃ ᓄᓇᕗᑦ ᐊᖏᕈᑎᖏᓐᓂ

You engage in traditional harvesting activity / ᐊᖑᓇᓱᖃᑕᐅᖃᑦᑕᓂᕐᓂᒃ ᐱᖅᑯᓯᑐᖃᒃᑯᑦ

Your household has not exceeded the annual funding limit ($2,000) in the applicable fiscal year. / ᐃᓪᓗᒥᐅᖃᑎᑎᓪᓗ ᐅᖓᑖᓃᓐᖏᑦᑐᑦ ᐊᕐᕌᒍᒥ ᑮᓇᐅᔭᑎᒍᑦ ᑭᒡᓕᓕᐊᖑᓯᒪᔪᓂᒃ ($2,000) ᐱᓇᓱᐊᕐᕕᒋᔭᑦ ᑮᓇᐅᔭᓕᕆᓐᓇᐅᑉ ᐊᕐᕌᒎᐊ

If applying for small and/or safety equipment program, you need financial assistance to purchase required harvesting equipment / ᑐᒃᓯᕋᕈᕕᑦ ᐱᖁᑎᕋᓛᒥᒃ ᐊᒻᒪᓗ/ᐅᕝᕙᓘᓐᓃᑦ ᐊᑦᑕᓇᐃᕐᓯᒪᓂᕐᒧᑦ ᐱᖁᑎᒥᒃ, ᑮᓇᐅᔭᑎᒍᑦ ᐃᑲᔪᖅᑕᐅᔭᕆᐊᖃᕐᓗᑎᑦ ᓂᐅᕕᐊᕆᓂᐊᖅᑕᕐᓄᑦ ᐊᖑᓇᓲᑎᒃᓴᒥᒃ ᐱᖁᑎᑖᕆᐊᖃᕐᓂᕐᓂᒃ

SMALL EQUIPMENT SUBSIDY

Receipts for small equipment are required. / ᓇᓕᖅᑲᐃᑦ ᓱᓇᒃᑯᑖᓄᑦ ᒥᑭᔫᑎᓄᑦ ᓂᐅᕕᐅᑎᒥᓃᑦ ᑐᓂᔭᕆᐊᓖᑦ.
75% of the equipment costs (including shipping costs) to a maximum of $1,000 per request and $2,000 per household each year / 75% ᓇᑉᐸᓪᓗᐊᖓ ᓅᑦᑐᖅᓯᐅᑏᑦ ᐊᑭᖏᑕ ᑭᓪᓕᖃᕐᑎᑕᐅᓪᓗᑎᖕ $1000ᓄᑦ ᐊᑐᓂ ᑐᑦᓯᕋᕐᑐᑦ ᐊᒻᒪ $2000 ᐊᑐᓂ ᐃᓪᓗᓖᑦ ᐊᕐᕌᒍᑕᒫᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

FISHING EQUIPMENT / ᐃᖃᓗᒐᓲᑎᑦT

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Bailer Price /ᐃᒪᐃᔭᐅᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Manual Water Pump Price / ᐊᒡᒐᒨᖅᑐᖅ ᐃᒪᐃᔭᐅᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Buoyant Heaving Line Price / ᐊᑦᑐᓈᖅ ᐳᑦᑕᖁᑎᓕᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Fishing Rods and Reels Price / ᐊᐅᓚᓴᐅᑏᑦ ᓂᒻᒫᕕᖏᓪᓗ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Fillet Knife Price / ᓴᕕᑯᑖᖕ ᐃᕐᕋᕕᔭᐃᒍᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Fishing Line Price / ᐅᔪᒃᑯᐊᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Fishing Net Price / ᓄᓗᐊᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Tackle Box/Tackle Price / ᓂᑦᓯᒃᑯᕕᒃ/ᐃᖃᓗᒐᓲᑎᒃᑯᕕᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Scales and Measuring Devices Price / ᐅᖁᒪᐃᓐᓂᕐᓂᐊᕈᑏᑦ ᐆᑦᑑᑏᓪᓗ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity) ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Fishing Waders Price / ᑲᒥᑯᑖᖕ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Wading Boots Price / ᑲᒫᓗᑯᑖᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Ice Auger Price / ᓂᐅᖅᑑᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Ice Fishing Electronics (Sonar Systems and Cameras) Price / ᑕᓯᕐᒥ ᐃᖃᓗᓐᓂᖕ ᖃᐅᔨᓴᐅᑏᑦ (ᐃᖅᑲᓯᐅᑏᑦ ᐊᑭᐊᔪᑦ ᐊᔾᔨᓕᐅᕈᑏᓪᓗ) ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

OUTDOOR EQUIPMENT / ᐊᐅᓪᓚᖅᓯᒪᓗᓂ ᐱᖁᑎᑦ:

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Tent / ᑐᐱᖅ

Sleeping Bag / ᐊᑦᑐᓈᖅ

Rope, Twine, Bungee Cord / ᐊᑦᑐᓈᖅ, ᐊᑦᑐᓈᕋᓛᖅ ᐃᕙᓗᐸᐅᔭᖅ, ᐊᑦᑐᓈᕋᓛᖅ ᐃᕙᓗᐸᐅᔭᖅ

Portable heater/camping stove / ᐅᖅᑰᓴᐅᑦ/ᓱᐴᔫᖅ

Tarp / ᐅᓕᑦᓴᔭ

Binoculars/rangefinder / ᐃᒡᒐᐅᔮᖕ/ᐅᖓᓯᓐᓂᖓᓄᑦ ᖃᐅᔨᓴᐅᑦ

Foam mattresses / ᐳᕙᐅᔭᖅ ᐊᓪᓕᓂᖅ

Caribou & Muskox skins: for tent camping / ᐊᒥᖅ ᑐᑦᑐᒧᑦ ᐅᒥᕐᒪᒧᓪᓗ; ᐊᓪᓕᓂᑦᓴᖅ ᑐᐱᕐᒥ ᑕᒻᒫᕐᓗᓂ

Portable Heater/Camping Stove Price / ᐅᖅᑰᓴᐅᑦ/ᓱᐴᔫᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Tent Price / ᑐᐱᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Tarp Price / ᐳᓪᓚᑎ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Binoculars/Rangefinder Price / ᐃᒡᒐᐅᔮᖕ/ᐅᖓᓯᓐᓂᖓᓄᑦ ᖃᐅᔨᓴᐅᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Caribou & Muskox Skins: For Tent Camping Price / ᐊᒥᖅ ᑐᑦᑐᒧᑦ ᐅᒥᕐᒪᒧᓪᓗ; ᐊᓪᓕᓂᑦᓴᖅ ᑐᐱᕐᒥ ᑕᒻᒫᕐᓗᓂ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Rope/Twine/Bungee Cord Price / ᐊᑦᑐᓈᖅ/ᕿᓚᕈᑏᑦ/ᑕᓯᔭᑦᑐᖅ ᐊᑦᑐᓈᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity) ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Foam Mattresses Price / ᐳᕙᐅᔭᖅ ᐊᓪᓕᓂᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Sleeping Bag Price / ᕿᐱᐊᓘᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

HUNTING TOOLS / ᐊᖑᓇᓱᓲᑎᓄᑦ ᓱᓇᒃᑯᑖᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Kakivak / ᑲᑭᕙᒃ

Harpoon / ᐅᓈᖅ

Nissik / ᓂᒃᓯᒃ

Sewing Machine / ᒥᖅᓲᑦ

Hunting Knife / ᓴᕕᒃ

Ulu / ᐅᓗ

Pana/Snow Knife / ᐸᓇ/ᐊᐳᑎᓯᐅᑦ ᓴᕕᒃ

Kakivak Price / ᑲᑭᕙᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Harpoon Price / ᐅᓈᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Nissik Price / ᓂᒃᓯᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Sewing Machine Price / ᒥᖅᓲᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Hunting Knife Price / ᓴᕕᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Ulu Price / ᐅᓗ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Pana/Snow Knife Price / ᐸᓇ/ᐊᐳᑎᓯᐅᑦ ᓴᕕᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

HUNTING OUTDOOR CLOTHING / ᐊᖑᓇᓱᓪᓗᓂ ᐊᓐᓄᕌᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Mitts / ᐳᐊᓘᖕ

Snow pants / ᖃᕐᓕᐊᓘᖕ

Hunting parka / ᖁᓕᑦᑕᐅᔭᖅ ᓅᑦᑐᖅᓯᐅᑦ

Boots/Kamiit / ᑲᒫᓘᒃ/ᑲᒦᖕ

Mitts Price / ᐳᐊᓘᖕ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Kamiit/Boots Price / ᑲᒦᖕ/ᕘᑦᑏᖕ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Snow Pants Price / ᖃᕐᓕᐊᓘᖕ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Hunting Parka Price / ᖁᓕᑦᑕᐅᔭᖅ ᓅᑦᑐᖅᓯᐅᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

HUNTING EQUIPMENT / ᐊᖑᓇᓲᑎᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Rifle and Rifle accessories (Ammunition/Scope/Mounts/Bolts/Rings, and clips) / ᖁᑭᐅᑦ ᐊᒻᒪᓗ ᖁᑭᐅᑎᓯᐅᑎᑦ (ᓴᒃᑯ/ᕿᕐᖑᑦ/ᑐᙵᕕᖓᑦ/ᕿᔾᔮᑦ/ᓱᓪᓗᓕᒃ, ᐊᒻᒪᓗ ᓴᒃᑯᖃᐅᑏᑦ)

Bow/crossbow / ᐱᓯᑦᓯᒃ/ᖁᑭᐅᑦᑕᐅᔭᖅ

Bag / ᐴᖅ

Thermos / ᓇᒻᒪᒑᖅ

Grub boxes to store fish or raw meat / ᓂᓪᓕᔪᐃᑦᑐᖅ/ᑕᖂᑎᑦ ᐃᖃᓗᖃᐅᑎᑦᓴᑦ ᓂᕿᓂᓪᓘᓐᓃᑦ ᒥᑭᒐᕐᓂᒃ/

Compressors / ᐳᓪᓚᑦᓴᐅᑦ

Lumber supplies to build Qamutik Price / ᕿᔪᑦᑖᕈᑎᑦᓴᒧᑦ ᖃᒧᓯᐅᕈᒪᔪᓄᑦ ᐊᑭᖓ

Bow/Crossbow Price / ᐱᓯᑦᓯᒃ/ᖁᑭᐅᑦᑕᐅᔭᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Bag Price / ᐴᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Thermos Price / ᓇᒻᒪᒑᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Lumber Supplies to Build Qamutik Price / ᕿᔪᑦᑖᕈᑎᑦᓴᒧᑦ ᖃᒧᓯᐅᕈᒪᔪᓄᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Rifle and Rifle Accessories (Ammunition/Scope/Mounts/Bolts/Rings, and clips) Price / ᖁᑭᐅᑦ ᐊᒻᒪᓗ ᖁᑭᐅᑎᓯᐅᑎᑦ (ᓴᒃᑯ/ᕿᕐᖑᑦ/ᑐᙵᕕᖓᑦ/ᕿᔾᔮᑦ/ᓱᓪᓗᓕᒃ, ᐊᒻᒪᓗ ᓴᒃᑯᖃᐅᑏᑦ)*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Grub Boxes to Store Fish or Raw Meat Price / ᑕᖂᑎᑦ ᐃᖃᓗᖃᐅᑎᑦᓴᑦ ᓂᕿᓂᓪᓘᓐᓃᑦ ᒥᑭᒐᕐᓂᒃ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Compressors Price / ᐳᓪᓚᑦᓴᐅᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

SNOWMOBILE PARTS / ᖃᒧᑕᐅᔭᑦ ᐃᓚᑦᓴᖏᓐᓄᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Belts / ᕿᓗᐊᖑᔭᖅ

Ice Scratchers / ᓂᓪᓕᑎᕈᑏᑦ

Linx Boxes / ᓱᓇᒃᑯᑖᖃᐅᑏᑦ ᐅᓯᒐᐃᑦ

Booster Packs / ᓱᓇᒃᑯᑖᖃᐅᑏᑦ ᐴᑦ ᖃᒧᑕᐅᔭᒨᓲᑦ

Tracks / ᐊᓗᐃᑦ

Hitch / ᑲᓗᑎ

Suspension / ᐳᓪᓚᐃᑦ

Snowmobile Trailer Tires / ᑲᓕᒐᐅᑉ ᐊᑦᓴᓗᐊᖏᑦ

Belts Price / ᕿᓗᐊᖑᔭᖅ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Ice Scratchers Price / ᓂᓪᓕᑎᕈᑏᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Linx Boxes Price / ᓱᓇᒃᑯᑖᖃᐅᑏᑦ ᐅᓯᒐᐃᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Booster Packs Price / ᓱᓇᒃᑯᑖᖃᐅᑏᑦ ᐴᑦ ᖃᒧᑕᐅᔭᒨᓲᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Tracks Price / ᐊᓗᐃᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Hitch Price / ᑲᓗᑎ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Suspension Price / ᐳᓪᓚᐃᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Snowmobile Trailer Tires Price / ᑲᓕᒐᐅᑉ ᐊᑦᓴᓗᐊᖏᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

BOAT PARTS / ᐅᒥᐊᕐᒧᑦ ᐃᓚᑦᓴᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Propellers / ᐸᐅᑏᑦ

Steering Kits / ᓴᖑᑦᑕᐅᑦ

Boat Seats / ᐅᒥᐊᒧᑦ ᐃᑦᓯᕚᕐᕖᑦ

Electric Starters / ᐅᐊᔭᒨᖅᑐᑦ ᐊᐅᓚᔾᔭᐃᑦ

Buoys / ᐳᑦᑕᖅᑯᑏᑦ

Inflatable rafts / ᐅᒥᐊᓛᑦ ᐳᓪᓚᑦᑕᔫᑦ

Small Boats (Umiangaq/Aissiuti) 12 ft. only and Boat trailer tires / ᒥᑭᔫᑏᑦ ᐅᒥᐊᑦ (ᐅᒥᐊᕐᖓᖅ/ᐊᐃᑦᓯᐅᑎ) 12 ᐃᑎᒐᐃᑦ ᑖᒃᑯᓄᖓᑐᐊᖅ ᐊᒻᒪᓗ ᐅᒥᐊᕐᒧᑦ ᑲᓕᒐᕐᓄᑦ ᐊᑦᓴᓗᐊᑦ.

Propellers Price / ᐸᐅᑏᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Steering Kits Price / ᓴᖑᑦᑕᐅᑦ ᐸᐅᑏᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Boat Seats Price / ᐅᒥᐊᒧᑦ ᐃᑦᓯᕚᕐᕖᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Electric Starters Price / ᐅᐊᔭᒨᖅᑐᑦ ᐊᐅᓚᔾᔭᐃᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Buoys Price / ᐳᑦᑕᖅᑯᑏᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Inflatable Rafts Price / ᐅᒥᐊᓛᑦ ᐳᓪᓚᑦᑕᔫᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Small Boats (Umiangaq/Aissiuti) 12 ft. only and Boat trailer tire's Price / ᒥᑭᔫᑏᑦ ᐅᒥᐊᑦ (ᐅᒥᐊᕐᖓᖅ/ᐊᐃᑦᓯᐅᑎ) 12 ᐃᑎᒐᐃᑦ ᑖᒃᑯᓄᖓᑐᐊᖅ ᐊᒻᒪᓗ ᐅᒥᐊᕐᒧᑦ ᑲᓕᒐᕐᓄᑦ ᐊᑦᓴᓗᐊᑦ. ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

ATV/UTV PARTS / ᓯᑕᒪᓕᓐᓄᑦ ATV/UTV ᐃᓚᑦᓴᑦ:

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Tracks / ᐊᓗᐃᑦ

Suspension / ᐳᓪᓚᖅ

Suspension ᐳᓪᓚᖅ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Tracks Price /ᐊᓗᐃᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

STORAGE / ᑐᖅᑯᐃᓯᒪᕕᒃ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Freezer/ ᖁᐊᖅᓰᕖᑦ

Bags / ᐴᑦᓴᐃᑦ

Vacuum Sealer / ᓂᕿᒧᑦ ᐴᑦᓴᐃᑦ ᒥᓪᓗᐊᕈᑎᑦ

Freezer Price / ᖁᐊᖅᓰᕖᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Vacuum Sealers Price/ ᓂᕿᒧᑦ ᐴᑦᓴᐃᑦ ᒥᓪᓗᐊᕈᑎᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Bags Price / ᐴᑦᓴᐃᑦ ᐊᑭᖓ*

Quantity / ᖃᑦᓯᑦ*

Subtotal (Price x Quantity)/ ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Other /ᐊᓯᖏᑦ

Please specify / ᓇᓗᓇᐃᙳᐊᑕᕐᓯᓐᓇᕈᒃ*

Other Price / ᓇᓗᓇᐃᕈᒪᙱᑦᑐᖅ*

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Small Equipment Totals / ᒥᑭᔫᑏᑦ ᓅᑦᑐᖅᓯᐅᑏᑦ ᑲᑎᓪᓗᒋᑦ

Receipts for small equipment are required. / ᓇᓕᖅᑲᐃᑦ ᓱᓇᒃᑯᑖᓄᑦ ᒥᑭᔫᑎᓄᑦ ᓂᐅᕕᐅᑎᒥᓃᑦ ᑐᓂᔭᕆᐊᓖᑦ.
You are eligible for 75% of the equipment costs to a maximum of $1,000 per application and $2,000 per household per year / 75% ᓇᑉᐸᓪᓗᐊᖓ ᓅᑦᑐᖅᓯᐅᑏᑦ ᐊᑭᖏᑕ ᑭᓪᓕᖃᕐᑎᑕᐅᓪᓗᑎᖕ $1000ᓄᑦ ᐊᑐᓂ ᑐᑦᓯᕋᕐᑐᑦ ᐊᒻᒪ $2000 ᐊᑐᓂ ᐃᓪᓗᓖᑦ ᐊᕐᕌᒍᑕᒫᑦ

Total Small Equipment Price / ᑲᑎᓪᓗᒋᑦ ᒥᑭᔫᑏᑦ ᓅᑦᑐᖅᓯᐅᑏᑦ ᐊᑭᖓ

Total Eligible Funding (75% of price) / ᑲᑎᓪᓗᒋᑦ ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Total Eligible Funding (75% of price of the total cost upto $1000) / ᑲᑎᓪᓗᒋᑦ ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

SAFETY EQUIPMENT / ᓱᓇᒃᑯᑏᑦ ᐊᑦᑕᓇᕐᔭᐃᕈᑏᑦ

Receipts for safety equipment are required. / ᓇᓕᖅᑲᐃᑦ ᐋᓐᓂᔾᔭᐃᒃᑯᑎᓄᑦ/ᐊᐃᑦᑐᖅᑕᐅᔾᔭᐃᒃᑯᑎᓄᑦ ᓂᐅᕕᐅᑎᒥᓃᑦ ᑐᓂᔭᕆᐊᓖᑦ..
75% of the equipment costs (including shipping costs) to a maximum of $1,000 per request and $2,000 per household each year / 75% ᓇᑉᐸᓪᓗᐊᖓ ᓅᑦᑐᖅᓯᐅᑏᑦ ᐊᑭᖏᑕ ᑭᓪᓕᖃᕐᑎᑕᐅᓪᓗᑎᖕ $1000ᓄᑦ ᐊᑐᓂ ᑐᑦᓯᕋᕐᑐᑦ ᐊᒻᒪ $2000 ᐊᑐᓂ ᐃᓪᓗᓖᑦ ᐊᕐᕌᒍᑕᒫᑦ

Select all that apply / ᑎᑎᕐᓯᕕᒋᓗᒋᑦ ᐃᓘᓐᓇᑎᒃ ᐊᑐᖅᑐᓕᒫᑦ*

Floater Suit/Life Jacket Price / ᐊᑦᑕᒃᑳᑦ ᐳᑦᑕᖁᑎᓖᑦ/ᐳᑦᑕᖁᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Radar Reflector Price / ᑕᐅᑑᑎᒧᑦ ᑕᑯᑦᓴᐅᒃᑲᕐᓂᕐᓇᕈᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Navigation Lights Price / ᑕᒻᒪᕇᒃᑯᑎᓄᑦ ᑐᕌᖓᔪᑦ ᖃᐅᒻᒪᖁᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Manual Propelling Device Price / ᐊᖑᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

SPOT Device Price / ᒫᓃᑉᐳᖔᕐᒫᕈᑏᑦ ᖃᕆᓴᐅᔭᒃᑯᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Satellite Phone Price / ᖃᖓᑦᑕᖅᑎᑕᐅᓯᒪᔪᒃᑯᑦ ᐅᖄᓚᐅᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

CB/VHF Radio Price / ᐆᕚᕈᑎᕋᓛᑦ/ᐅᕚᕈᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Compass/GPS Price / ᑕᒻᒪᕇᒃᑯᑏᑦ/ᖃᖓᑦᑕᖅᑎᑕᐅᓯᒪᔪᒃᑯᑦ ᑕᒻᒪᕇᒃᑯᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Headlamp Price / ᓂᐊᖁᑏᓖᑦ ᖃᐅᒻᒪᖅᑕᔫᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Flashlight Price / ᖃᐅᒻᒪᖅᑕᔫᖅ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

First Aid Kit Price / ᐋᓐᓂᖅᑐᖃᕐᐸᑦ ᒪᑦᑐᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Thermal Pack Price / ᐊᒡᒐᐃᓱᐃᖅᓯᕈᑏᑦ ᐆᓇᔪᑦᑐᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Reboarding Device Price / ᐃᑭᒋᐊᕈᑏᑦ ᑐᒻᒥᕕᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Gun Cases/Locks Price / ᖁᑭᐅᒻᒧᑦ ᐴᑦ/ᑮᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Fire Extinguishers Price / ᖃᑦᑎᕈᑏᑦ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Qulliq/Oil Lanterns/Wicks for Heaters/Zippo Lighter Price / ᖁᓪᓕᖅ/ᐅᖅᓱᒨᖅᑐᖅ ᖃᐅᒪ/ᒪᓃᑦ ᐅᖅᑰᓴᐅᒻᒧᑦ/ᓯᒃᑭᑦᑕᖅ ᐃᓐᓇᒃ ᐊᑭᖓ*

Quantity/ ᖃᑦᓯᑦ*

Subtotal(QuantityxPrice) / ᑲᑎᓐᓂᖓ (ᐊᑭᖓ x ᖃᑦᓯᐅᓂᖏᓪᓗ)

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Other (Please Specify) / ᐊᓯᖏᑦ (ᓇᓗᓇᐃᕐᓗᒋᑦ)*

Other Price / ᓇᓗᓇᐃᕈᒪᙱᑦᑐᖅ*

Eligible Funding (75% of price) / ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)*

Safety Equipment Totals / ᓱᓇᒃᑯᑏᑦ ᐊᑦᑕᓇᕐᔭᐃᕈᑏᑦ ᑲᑎᓪᓗᒋᑦ

You are eligible for 75% of the equipment costs to a maximum of $1,000 per application and $2,000 per household per year / 75% ᓇᑉᐸᓪᓗᐊᖓ ᓅᑦᑐᖅᓯᐅᑏᑦ ᐊᑭᖏᑕ ᑭᓪᓕᖃᕐᑎᑕᐅᓪᓗᑎᖕ $1,000ᓄᑦ ᐊᑐᓂ ᑐᑦᓯᕋᕐᑐᑦ ᐊᒻᒪ $2,000 ᐊᑐᓂ ᐃᓪᓗᓖᑦ ᐊᕐᕌᒍᑕᒫᑦ

Total Safety Equipment Price / ᑲᑎᓪᓗᒋᑦ ᓱᓇᒃᑯᑏᑦ ᐊᑦᑕᓇᕐᔭᐃᕈᑏᑦ ᐊᑭᖓ

Total Eligible Funding (75% of price) / ᑲᑎᓪᓗᒋᑦ ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

Total Eligible Funding (75% of price of the total cost upto $1000) / ᑲᑎᓪᓗᒋᑦ ᑮᓇᐅᔭᕐᑖᖑᔪᓐᓇᕐᑐᑦ (ᓇᑉᐸᖓ ᐊᑭᖓᑕ)

INSURANCE COVERAGE / ᓇᓪᓕᐅᒃᑯᒫᑦ

Insurance – Small Equipment / ᓇᓪᓕᐅᒃᑯᒫᑦ – ᒥᑭᔫᑎᓄᑦ ᐱᖁᑎᓄᑦ

(75% of the insurance premium to a maximum of $1,000 per equipment, $2,000 per household each year.) / (75% ᓇᓪᓕᐅᒃᑯᒫᒻᒪᕆᓐᓄᑦ ᐊᖏᓂᖅᐹᖑᒍᓐᓇᖅᑐᖅ $500 ᐊᑕᐅᓯᕐᒧᑦ ᐱᖁᑎᒧᑦ ᐊᒻᒪᓗ $1,500 ᐃᓪᓗᒥᐅᖃᑎᒌᓄᑦ ᐊᕐᕌᒍᑕᒫᑦ)

Insurance – Safety Equipment / ᓇᓪᓕᐅᒃᑯᒫᑦ – ᐊᑦᑕᓇᐃᖅᓯᒪᓂᕐᒧᑦ ᐱᖁᑎᓄᑦ

Insurance – Large Hunting Equipment / ᓇᓪᓕᐅᒃᑯᒪᑦ – ᐊᖏᔫᑏᑦ ᐊᖑᓇᓲᑏᑦ ᐱᖁᑎᑦ

(75% of the insurance premium to a maximum of $1,000 per equipment, $2,000 per household each year.) / (75% ᓇᓪᓕᐅᒃᑯᒫᒻᒪᕆᓐᓄᑦ ᐊᖏᓂᖅᐹᖑᒍᓐᓇᖅᑐᖅ $1,000 ᐊᑕᐅᓯᕐᒧᑦ ᐱᖁᑎᒧᑦ ᐊᒻᒪᓗ $2,000 ᐃᓪᓗᒥᐅᖃᑎᒌᓄᑦ ᐊᕐᕌᒍᑕᒫᑦ)
(“Large Hunting Equipment” refers to snowmobiles, ATV’s or UTVs (Side-by-sides), boats and outboard motors with an initial purchase price of $5,000 or more.) / (ᐊᖏᔫᑏᑦ ᐊᖑᓇᓲᑏᑦ ᐱᖁᑎᑦ” ᑖᒃᑯᐊᖑᓂᕋᖅᑕᐃᑦ ᖃᒧᑕᐅᔭᑦ, ᓯᑕᒪᓖᑦ ᐅᕝᕙᓘᓐᓃᑦ UTV (ᓯᐊᓪᓗᓂ ᐃᑭᒪᕕᑦᓴᑦ), ᐅᒥᐊᑦ ᐊᐅᓚᐅᑏᓪᓗ ᐅᒥᐊᖅᓯᐅᑏᑦ ᓂᐅᕕᐊᕆᓗᒋᑦ ᐊᑭᓖᑦ $5,000 ᐅᖓᑖᓂᓘᓐᓃᑦ)

Total Insurance Cost/ ᑲᑎᓐᓂᖏᑦ ᓇᓪᓕᐅᒃᑯᒫᑦ ᐊᑭᖏᑦ

Total Amount Requested / ᑲᑎᓪᓗᒋᑦ ᐅᓄᕐᓂᖏᑕ ᑐᒃᓯᕌᖑᔪᑦ

(75% of the Total Insurance Cost, up to $500 – Small and Safety Equipment $1,000 – Large Equipment) /(75% ᑲᑎᓪᓗᒋᑦ ᓇᓪᓕᐅᒃᑯᒫᒧᑦ ᐊᑭᖏᑦ, ᑎᑭᐅᑎᓯᒪᔪᑦ $500 – ᒥᑭᔫᑎᓄᑦ ᐊᑦᑕᓇᐃᖅᓯᒪᓂᕐᒧᓪᓕᓗ ᐱᖁᑎᓄᑦ $1,000 – ᐊᖏᔫᑎᓄᑦ ᐱᖁᑎᓄᑦ)

HOUSEHOLD INFORMATION / ᐃᓪᓗᒥᐅᖃᑎᒌᓂᒃ ᑐᓴᐅᒪᑎᑦᓯᒍᑏᑦ

(Your household includes your legal or common-law spouse. Your parents, children or other family members or relatives living in the same house who are 16 years of age or older are considered a separate house) / (ᐃᓪᓗᒥᐅᖃᑕᐅᓂᕋᖅᑕᐅᔪᑦ ᒪᓕᒐᖅᑎᒍᑦ ᐊᐃᑉᐸᐃᑦ ᐅᕝᕙᓘᓐᓃᑦ ᓄᓕᐊᓱᐃᑦ/ᐅᐃᓱᐃᑦ. ᐊᖓᔪᖅᑳᒃᑭᒃ, ᕿᑐᕐᖓᑎᑦ ᐅᕝᕙᓘᓐᓃᑦ ᐊᓯᖏᑦ ᐃᓚᑎᑦ ᐃᓪᓗᒥᐅᖃᑎᒋᔭᐅᔪᑦ ᐅᑭᐅᓖᑦ 16-ᓂᒃ ᐅᖓᑖᓂᓘᓐᓃᑦ ᐃᖕᒥᒃᑰᖓᔪᑦ ᐃᓪᓗᒥᐅᖃᑎᒌᓐᓂᕋᖅᑕᐅᓂᖏᑦ)

For Small and Safety Equipment Application Only/ ᒥᑭᔫᑎᓄᑦ ᐊᑦᑕᓇᐃᖅᓯᒪᒍᑎᓄᓪᓗ ᐱᖁᑎᓄᑦ ᑐᒃᓯᕋᐅᑎ ᑖᒃᑯᓄᖓᑐᐊᖅ

Name-1 / ᐊᑎᖓ 1

First Last

Relationship / ᑭᓇᒋᔭᐅᓂᖓ

Name-2 / ᐊᑎᖓ 2

First Last

Relationship / ᑭᓇᒋᔭᐅᓂᖓ

Name-3 / ᐊᑎᖓ 3

First Last

Relationship / ᑭᓇᒋᔭᐅᓂᖓ

Name-4 / ᐊᑎᖓ 4

First Last

Relationship / ᑭᓇᒋᔭᐅᓂᖓ

Name-5 / ᐊᑎᖓ 5

First Last

Relationship / ᑭᓇᒋᔭᐅᓂᖓ

ATTACHMENTS / ᐃᓚᓕᐅᑎᓯᒪᔪᑦ

PLEASE ENSURE TO INCLUDE THE FOLLOWING ATTACHMENTS:/ ᑖᒃᑯᐊ ᐃᓚᓕᐅᑎᒋᐊᓖᑦ ᐳᐃᒍᑦᑕᐃᓕᒃᑭᑦ:*

For small/safety equipment, insurance rebate, purchase receipt or proof of payment/down payment, or a brief description of the equipment you plan to purchase / ᐱᖁᑎᕋᓛᓄᑦ/ᐊᑦᑕᓇᐃᕐᓯᒪᒍᑎᓄᑦ, ᓂᐅᕕᐊᒥᓂᕆᒋᐊᑦᓴᕕᒋᑦ ᓇᓗᓇᐃᕐᓯᒍᑦ ᓇᓕᖅᑲᖅ/ᑎᒍᓯᔾᔪᑎ, ᐅᕝᕙᓘᓐᓃᑦ ᓇᓗᓇᐃᒐᓛᓪᓗᒍ ᐱᖁᑎ ᓂᐅᕕᐊᕆᓇᓱᐊ

File / ᓇᓗᓇᐃᒃᑯᑕᖓ

Drop files here or

Max. file size: 300 MB.

Brief description of the equipment you plan to purchase / ᐅᕝᕙᓘᓐᓃᑦ ᓇᓗᓇᐃᒐᓛᓪᓗᒍ ᐱᖁᑎ ᓂᐅᕕᐊᕆᓇᓱᐊᖅᑕᐃᑦ

DECLARATION / ᓱᓕᓂᕋᐅᑦ

Consent / ᐊᖏᕈᑦ*

I agree to the privacy policy. / ᐊᖏᖅᑐᖓ ᖃᐅᔨᒪᔭᐅᔭᕆᐊᖃᙱᑦᑐᑦ ᐊᑐᐊᒐᖏᑕ ᒥᔅᓵᓄᑦ

I am applying for funding assistance under the Harvesting Equipment Program administered by Nunavut Harvesters Support Program (NHSP).

To the best of my knowledge, all of the statements or information in this application are true.
I understand that any false or misleading information will result in my application being denied and may disqualify my organization or myself from receiving future funding assistance from NHSP or Qikiqtani Inuit Association (QIA).

I promise that any assistance received under this program will be used for the proposed harvesting equipment only.

I give permission to NHSP to collect and use my personal information related to this application and to make inquiries needed to evaluate this application. Upon receiving assistance, I will agree to supply any relevant receipts, records or other relevant information requested by NHSP.
My receipt of assistance will not make me an employee, contractor, or agent of NHSP or QIA.

ᑐᒃᓯᕋᐅᑎᒐ ᑮᓇᐅᔭᑎᒍᑦ ᐃᑲᔪᖅᑕᐅᔾᔪᑎᒃᓴᓂᒃ ᑖᒃᑯᑎᒎᓇ ᐊᖑᓇᓲᑎᓄᑦ ᐱᖁᑎᓄᑦ ᐃᑲᔫᑎᒃᓴᓂᒃ ᐊᐅᓚᑕᐅᔪᒥᒃ ᓄᓇᕗᑦ ᐊᖑᓇᓱᒃᑎᓄᑦ ᐃᑲᔫᑎᒃᓴᓕᕆᔨᒃᑯᓐᓂᒃ (NHSP).
ᖃᐅᔨᒪᓂᒃᑯᑦ, ᑎᑎᕋᖅᑕᐅᔪᓕᒫᑦ ᑐᓴᕈᑎᓕᐊᖑᔪᓕᒫᓪᓘᓐᓃᑦ ᑖᒃᑯᓇᓂ ᑐᒃᓯᕋᐅᑎᓂ ᓱᓕᔪᑦ. ᑐᑭᓯᔪᖓ ᓱᓕᙱᑦᑐᓂᒃ ᐅᕝᕙᓘᓐᓃᑦ ᐱᔭᖅᑯᒻᒥ ᓱᓕᙱᑦᑐᓂᒃ ᑐᓴᕈᑎᓕᐅᖅᑐᖅ ᑐᒃᓯᕋᐅᑎᖓ ᕿᐱᓗᒃᑕᐅᑦᓴᐅᑎᒋᓂᐊᖅᑐᖅ ᐊᒻᒪᓗ ᐊᔪᓕᖅᑎᑕᐅᓗᑎᒃ ᑲᑐᔾᔨᖃᑎᒌᓐᓃᕕᒃᑲ ᐅᕙᖓᓘᓐᓃᑦ ᓯᕗᓂᑦᑎᓐᓂ ᑮᓇᐅᔭᑎᒍᑦ ᐃᑲᔪᖅᑕᐅᓂᕐᒥᒃ NHSP−ᑯᓐᓂᒃ ᐊᒻᒪᓗ/ᐅᕝᕙᓘᓐᓃᑦ ᕿᑭᖅᑕᓂ ᐃᓄᐃᑦ ᑲᑐᔾᔨᖃᑎᒌᓂᒃ (QIA).

ᓱᓕᓪᓗᖓ ᐃᑲᔪᖅᑕᐅᔾᔪᑎᓕᒫᒃᑲ ᑖᒃᑯᑎᒎᓇ ᐊᐅᓚᓂᐅᔪᒃᑯᑦ ᐊᑐᖅᑕᐅᓂᐊᕐᓂᖏᓐᓂᒃ ᑐᒃᓯᕋᐅᑕᐅᔪᒧᑦ ᐊᖑᓇᓱᓐᓂᕐᒧᑦ ᐊᐅᓚᑕᐅᔪᐃᓐᓇᕐᓄᑦ.

NHSP−ᑯᑦ ᓄᐊᑦᓯᔪᓐᓇᑎᑉᐸᒃᑲ ᐊᑐᕐᓗᑎᓪᓗ ᐅᕙᖓ ᖃᐅᔨᒪᔭᐅᔾᔪᑎᖓᓂᒃ ᐊᒃᑐᐊᔪᓂᒃ ᑖᑦᓱᒧᖓ ᑐᒃᓯᕋᐅᒻᒧᑦ ᐊᒻᒪᓗ ᑐᑭᓯᒋᐊᕈᒪᑉᐸᑕ ᖃᐅᔨᓴᕐᓗᑎᒃ ᑖᑦᓱᒥᖓ ᑐᒃᓯᕋᐅᒻᒥᒃ. ᐃᑲᔪᖅᑕᐅᔾᔪᑎᑖᓚᐅᖅᑎᓪᓗᖓ, ᐊᖏᕈᑎᖃᕐᐳᖓ ᑐᓂᓯᓂᐊᕐᓂᕐᒥᒃ ᓇᓕᖅᑲᓂᒃ, ᑎᑎᕋᖅᓯᒪᔪᓂᒃ ᐅᕝᕙᓘᓐᓃᑦ ᐊᓯᖏᓐᓂᒃ ᐊᒃᑐᐊᔪᓂᒃ ᑐᓴᐅᒪᔾᔪᑎᓂᒃ ᑐᒃᓯᕌᖑᑉᐸᑕ NHSP−ᑯᓐᓂᒃ.

ᐃᑲᔪᖅᑕᐅᔾᔪᑎᒐ ᐃᖅᑲᓇᐃᔭᖅᑎᕈᕈᑎᒋᔾᔮᖏᑦᑕᕋ, ᑳᓐᑐᓛᒃᑕᐅᓂᕐᒧᑦ, ᑭᒡᒐᖅᑐᐃᓂᕐᒧᓘᓐᓃᑦ NSHP−ᑯᓐᓂᒃ ᕿᑭᖅᑕᓂᒃᑯᓪᓘᓐᓃᑦ.

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