ALGONQUINS OF PIKWAKANAGAN

ON - RESERVE BUSINESS REGISTRATION FORM

DATE:

BUSINESS REGISTRATION

1. Applicant’s Name:

2. Applicant’s Address:

3. Name of Business to be Registered:

4. Mailing Address (if different than residence):

5. Phone Number: Residence: Office:

6. Fax Number: Residence: Office:

7. Is there a business plan attached: Yes No

8. Is this business already in operation: Yes No

9. Type of Business:

10. Will this business create employment opportunities: Yes No

11. Are you presently registered with the Federal Government or a self-regulating professional body with respect to the conduct of your business? Yes No (If yes, applicant must provide proof and give details below.)

12. Are you bonded with a bonding agency with respect to the conduct of your business? Yes No (If yes, applicant must provide proof and give details below.)

13. Is the business incorporated? Yes No Federal Provincial (If yes, applicant must provide details below.)