Kivalliq Inuit Association $500 Gift Card Application Form

    $500 Gift Card Application Form
    For all Kivalliq Beneficiary Inuit Living outside of the Kivalliq Region

    1. APPLICANT INFORMATION

    ***PLEASE NOTE*** This application form is meant only for those Kivalliq Inuit living outside of the Kivalliq Communities where the KIA staff will mail a gift certificate to you. If you live in the Kivalliq Region, the gift cards will be made available at a pickup-location in your home communities. If applying, you must state that which Kivalliq Community that your NTI Beneficiary Card Number is registered to. Please note all fields are required. All applicants can only apply if they are 16 years of Age or older on April 1, 2021. (The date of birth at April 1, 2005 or earlier)

    Full Name:(as it appears on your NTI Card)
    NTI Number:
    Date of Birth:
    Registered Community:
    Mailing Address:
    City/Town:
    Postal Code:
    Is there additional Beneficiaries that will apply where we could mail the gift cards to the same address?
    If Yes, please list each even if they applied as well. Everyone needs to apply.
    Home Phone:
    Cell Phone:
    Email Address: