"Wildlife Damage Prevention Program General Application Form" - Nunavut, Canada

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ᐊᕙᑎᓕᕆᔨᒃᑯᑦ
Department of Environment
Avatiliqiyikkut
Ministère de l’Environnement
Wildlife Damage Prevention Program
General Application Form
Contact Person:
____________________________________
Community:
_______________________________________
House Number:
______________
Telephone Number: (867)
_____________________
Mailing Address:
____________________________________
E-mail:
_____________________________________
☐ Individual
☐ Group (Inc. Household)
Applicant Claiming on Behalf of:
If Group, indicate group name, number of people in group and your role in the group:
Complete Project Application Form attached
I acknowledge that failure to put into service the equipment or materials within 2 years
of receiving may result in the loss of that equipment
________
(initials).
 
 
 
(867) 975-770
P.O. Box 1000, Stn. 1320
 
(867) 975-7740
Iqaluit, Nunavut X0A 0H0
www.env.gov.nu.ca
 
 
ᐊᕙᑎᓕᕆᔨᒃᑯᑦ
Department of Environment
Avatiliqiyikkut
Ministère de l’Environnement
Wildlife Damage Prevention Program
General Application Form
Contact Person:
____________________________________
Community:
_______________________________________
House Number:
______________
Telephone Number: (867)
_____________________
Mailing Address:
____________________________________
E-mail:
_____________________________________
☐ Individual
☐ Group (Inc. Household)
Applicant Claiming on Behalf of:
If Group, indicate group name, number of people in group and your role in the group:
Complete Project Application Form attached
I acknowledge that failure to put into service the equipment or materials within 2 years
of receiving may result in the loss of that equipment
________
(initials).
 
 
 
(867) 975-770
P.O. Box 1000, Stn. 1320
 
(867) 975-7740
Iqaluit, Nunavut X0A 0H0
www.env.gov.nu.ca
 
 
ᐊᕙᑎᓕᕆᔨᒃᑯᑦ
Department of Environment
Avatiliqiyikkut
Ministère de l’Environnement
Use of equipment and materials outside of the purpose of preventing human-wildlife
conflict will result in future WDPP applications to be rejected and MAY prevent damage
compensation claims from being approved
________
(initials).
______________________________________
___________________
Applicant Signature
Date
 
 
 
(867) 975-770
P.O. Box 1000, Stn. 1320
 
(867) 975-7740
Iqaluit, Nunavut X0A 0H0
www.env.gov.nu.ca
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