Kivalliq Harvesters Support Grant Application

Kivalliq Harvesters Support Grant

Full Name (as appears on ID):(Required)

Date of Birth(Required)

NTI Number(Required)

Community(Required)

House # and Street Address:

PO Box

Email(Required)

Home Phone

Cell Phone

Type of Equipment Purchased(Required)

Make and Model of Equipment

Please provide year, make and model of equipment for this program. (Arctic Car, Honda, Ski-doo, Yamaha, Polaris, Mercury, Etc..)

Vehicle Identification Number (VIN)(Required)

Vehicles from model year 1981 to present have a VIN made up of 17 characters (letters and numbers) Note: for Boat please include hull ID stated from Manufacture and VIN of Outboard if included.

Shipping to Community(Required)

Select the community that the equipment is being shipped to.

Shipping from

File Uploads(Required)

Please upload Bill of sale, Proof of payment for 25% of Freight or quote stating freight charges

Drop files here or

Max. file size: 50 MB.

Electronic Funds transfer (EFT)

Please attach a void cheque / account information for EFT payment, otherwise a cheque will be issued to your mailing address.

Max. file size: 50 MB.

Applicant Eligibility(Required)

You are 16 years of age and enrolled in the Nunavut Agreement

You engage in harvesting activities

You are a resident of the Kivalliq region

Declaration and Submission(Required)

By clicking on the submit button below, I declare that I am applying for funding assistance under the Kivalliq Harvesters Support Grant administered by the Kivalliq Inuit Association. I swear that 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 Kivalliq Inuit Association (KIA). I promise that any assistance received under this program will be used for the proposed harvesting equipment only. I give permission to KIA to collect and use my personal information related to this application to make inquiries needed to evaluate this application. My receipt of assistance will not make me an employee, contractor or agent of KIA. I further believed this declaration to be true and know that it is the same as if made under oath.