Yukon Geographical Place Name Submission Form
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2No. ___________
YUKON GEOGRAPHICAL PLACE NAME SUBMISSION
Tourism and Culture
Cultural Services Branch
This information is being collected under the authority of the Minister of Tourism and Culture for the purpose of determining the
suitability of suggested names for geographical features in Yukon.
For further information contact/direct inquiries to Garry Njootli, Yukon Toponymist (L-1), Heritage Resources Unit, Cultural
Services Branch, Government of Yukon, P.O. Box 2703, Whitehorse, Yukon, Y1A 2C6. Telephone No. (867) 667-3099.
Name: _____________________________________
Phone: ______________________
Date: __________
Address: __________________________________________________________________________________
E-mail: ______________________________________________________
1. What type of feature or place do you wish to have named? (Mountain, River, Lake, etc.) __________________________
__________________________________________________________________________________________
2. What is the name proposed or rescinded? __________________________________________________________
3. Why do you wish this feature or place to be given the specific name suggested or the name to be changed? ___________
__________________________________________________________________________________________
4. Where is the Feature or Place situated?
Lat.________________ Long.__________________ UTM________________________ Photo included
Y
N
Map number (National Topographic System Map or ArcView GIS), e.g. 105D03 _________
Photocopy of part of map should be included indicating the location and extent of the feature or place 1: 50,000 scale maps
preferred (NAD 83).
5.Are you aware of any other name or names that have been used for this place? If so please explain their meanings or origins.
_________________________________________________________________________________________
____________________________________________________________________________________
6. If your proposed name is in recognition of a particular person, is that person deceased?
Y, When: _____________
N
7. Please give a list of the names and addresses of your informants for this proposed name:
name
address
phone
a) ________________________________________________________________________________________
b) ________________________________________________________________________________________
c) ________________________________________________________________________________________
8. Is this the “correct” spelling for the place that you would like to be named?
Y
N
Don’t know
Correct spelling, if known: _______________________________________________________________________
9. Is your proposed name located on Settlement Land?
Y, If known ____________________________________
N
YG(5938EQ)F2 07/2013
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