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Nuchatlaht First Nation

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intake form

EVENT GATHERING:

Primary Applicant Information

* Indicates required field

Primary Applicant *

First

Last

Email *

Phone Number *

Additional Attendees

# of additional guests *

Please include everyone that will be attending with you. Immediate family members are permitted to attend Nuchatlaht events.

Name *

First

Last

Age (if applicable) *

If catered event, please indicate any dietary restrictions *

Registered with Nuchatlaht? *

Yes No To be registered

Name *

First

Last

Age (if applicable) *

If catered event, please indicate any dietary restrictions *

Registered with Nuchatlaht? *

Yes No To be registered

Name *

First

Last

Age (if applicable) *

if catered event, please indicate any dietary restrictions *

Registered with Nuchatlaht? *

Yes No To be registered

Name *

First

Last

Age (if applicable) *

if catered event, please indicate any dietary restrictions *

Registered with Nuchatlaht? *

Yes No To be registered

Name *

First

Last

Age (if applicable) *

If catered event, please indicate any dietary restrictions *

Registered with Nuchatlaht? *

Yes No To be registered

Name *

First

Last

Age (if applicable) *

if catered event, please indicate any dietary restrictions *

Registered with Nuchatlaht? *

Yes No To be registered

Transportation information:

Please indicate your method of travel *

Please indicate all services you may require to attend this event: *

Local Taxi Transportation Bus BC Ferry Service Fuel Reimbursement (Fuel Gift Card)

If you require additional services to attend any Nuchatlaht hosted event, please get in touch with the Band Office to arrange a method of travel.

Primary Driver (if different than primary applicant) *

First

Last

If your Primary Driver is different than Primary Applicant: Primary applicant is still eligible for fuel reimbursement and may include Primary Driver in their Guest List to attend.

City travelling from *

Is your mailing address up to date with our office? *

Yes No Unsure

If no, please provide full mailing address including postal code *

Overnight Accommodations

Nuchatlaht members facing scheduling barriers or travelling long distances when attending our events may request overnight accommodations to be able to attend our events. Overnight Requests will be reviewed by Management prior to approval if it is deemed necessary. Nuchatlaht will remain contact with Primary Applicant in regards to overnight accommodation requests to notify of Approval and Location.

Do you require overnight accommodations to attend this event? *

Yes No

Note: If you require overnight accommodations and you are unable to show up to attend, please notify the Band Office immediately to avoid any no-show charges.

If yes, please indicate why you need overnight accommodations *

How many will be in your room? *

Note: Due to room capacity restrictions, a maximum of 4 per party will be allowed for accommodations. Only one room will be reserved per family.

Primary Name for Check In *

First

Last

Expected Check In Date *

Expected Departure Date *