I am registering for Pigiarutit Online (Winter 2023)

Name *

First Name

Last Name

Phone *

(###)

###

####

Mailing Address *

Please provide a mailing address you can be reached at

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you an Inuk / Nunavut Land Claim beneficiary? *

Funding for some of Pirurvik's programs are specifically for Inuit.

Yes

No

Date of Birth *

MM

DD

YYYY