Application For A Wilderness Tourism Licence Page 4
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4Part 6. List of guides and field employees
1
Guide or
Employee
Last name ______________________________ First Name ______________________
Date of birth (y/m/d) ______________
Mailing address ______________________________________________________________
Postal code _________________
City ________________________________ Territory/Province/State ________________________ Country _________________
Physical address __________________________________________________________________________________________
Citizenship
Canadian
work visa (if required) ______________________________________________________
Certifications
First Aid, certification date (y/m/d) __________________ expiry date (y/m/d)______________
CPR, level “C,” certification date (y/m/d)______________ expiry date (y/m/d)______________
Valid certificates attached
First Aid
CPR, level “C”
2
Guide or
Employee
Last name ______________________________ First Name ______________________
Date of birth (y/m/d) ______________
Mailing address ______________________________________________________________
Postal code _________________
City ________________________________ Territory/Province/State ________________________ Country _________________
Physical address __________________________________________________________________________________________
Citizenship
Canadian
work visa (if required) ______________________________________________________
Certifications
First Aid, certification date (y/m/d) __________________ expiry date (y/m/d)______________
CPR, level “C,” certification date (y/m/d)______________ expiry date (y/m/d)______________
Valid certificates attached
First Aid
CPR, level “C”
3
Guide or
Employee
Last name ______________________________ First Name ______________________
Date of birth (y/m/d) ______________
Mailing address ______________________________________________________________
Postal code _________________
City ________________________________ Territory/Province/State ________________________ Country _________________
Physical address __________________________________________________________________________________________
Citizenship
Canadian
work visa (if required) ______________________________________________________
Certifications
First Aid, certification date (y/m/d) __________________ expiry date (y/m/d)______________
CPR, level “C,” certification date (y/m/d)______________ expiry date (y/m/d)______________
Valid certificates attached
First Aid
CPR, level “C”
4
Guide or
Employee
Last name ______________________________ First Name ______________________
Date of birth (y/m/d) ______________
Mailing address ______________________________________________________________
Postal code _________________
City ________________________________ Territory/Province/State ________________________ Country _________________
Physical address __________________________________________________________________________________________
Citizenship
Canadian
work visa (if required) ______________________________________________________
Certifications
First Aid, certification date (y/m/d) __________________ expiry date (y/m/d)______________
CPR, level “C,” certification date (y/m/d)______________ expiry date (y/m/d)______________
Valid certificates attached
First Aid
CPR, level “C”
Applicant’s initials __________
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