Application For A Wilderness Tourism Licence
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4Wilderness Tourism Licensing Act
APPLICATION FOR A
WILDERNESS TOURISM LICENCE
Environnement
Licence Number
Instructions
• Ensure that you are familiar with the Wilderness Tourism Licensing Act and Regulations.
• Ensure that each section is completed and that all information is clearly printed or typed.
• Ensure that each page is initialled by the applicant in the space provided at the bottom of the page, and
the signature block is signed at the end of the application.
• Ensure that all attachments and the appropriate licence fee is submitted with the application.
• To avoid confusion over dates, enter year, month, day.
The Registrar may request additional information upon receipt of this application.
Confidentiality: This information is being collected under the authority of the Wilderness Tourism Licensing Act
and will be used only for the purpose of research, statistical and enforcement purposes. For further information
direct inquiries to Registrar, Wilderness Tourism Licensing (867) 667-5648, or 1-800-661-0508 ext. 5648. Data
will be collected and used in a way that ensures operator confidentiality, and reflects governments obligations
under the Access to Information and Protection of Privacy Act.
Part 1. Applicant information
OPERATOR/BUSINESS/COMPANY NAME:
CONTACT NAME:
POSITION:
MAILING ADDRESS (BOX NUMBER/STREET ADDRESS):
TOWN/CITY:
PROVINCE/TERRITORY/STATE:
COUNTRY:
POSTAL/ZIP CODE:
RESIDENT ADDRESS (STREET ADDRESS):
TOWN/CITY:
TELEPHONE:
FAX:
E-MAIL:
Citizenship
Canadian
Other _______________________
If you are not a Canadian citizen or a landed immigrant, do you have a work visa or other papers?
Yes
No
Please explain. ___________________________________________________________________________
________________________________________________________________________________________
Corporate or business information
An operator applying for a licence under the Wilderness Tourism Licensing Act requires proof of Yukon
incorporation or registration under the Business Corporation Act . Please check the appropriate box and attach a
copy of your business registration.
Incorporation under the Business Corporation Act , or
Extra-territorial registration under the Business Corporation Act , or
Registration under the Partnership and Business Names Act .
Corporate address (if different from above) ______________________________________________________
Jurisdiction of corporate registration ____________________________________________________________
YG(4830QE)F4 Rev.05/2002
Applicant’s initials __________
page 1/4
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