This form is for applying to represent CAFN on boards and committees. Please complete this form and submit with your resume . If you need help to complete this application or require additional information on boards and committees, in the interim please contact Holly Underschultz. Date MM slash DD slash YYYY Applicant Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country CAFN Citizen(Required) Yes No Yukon Resident(Required) Yes No Resident on Traditional Territory(Required) Yes No Phone DaytimePhone EveningEmail Have you previously represented CAFN on a board or committee? Yes No List below and indicate the number of years servedWhat boards, committees, commissions or councils do you currently sit on?Please describe why you are interested in being part of this board or committee.What is your availability to serve on this board or committee (i.e. are you available evenings, weekends, any time of week)?Are you currently employed? Yes No What is your occupation? Employer Can you provide a criminal record check if requested? Yes No Are you aware of any conflict of interest that could impact your participation on this Board or Committee? Yes No Please explainPlease choose your top THREE (3) boards or committees you are interested in serving on: Champagne Aishihik Trust Board Sha Shäw Corporation (formerly CA Community Corp) Dakwäkäda Investment Corporation CAFN Housing Committee CAFN Lands Committee CAFN Language, Culture and Heritage Advisory Committee Alsek Renewable Resource Council Kluane National Park Management Board Yukon Salmon Sub-Committee – Alsek River Basin St. Elias School Council Tatshenshini Alsek Park Management Board Please upload your resumeMax. file size: 128 MB.Please note, Yukon First Nation people may apply to sit on territory-wide boards and committees through the Council of Yukon First Nations http://cyfn.ca/services/boards-committees/ or Yukon Government boards and committees http://www.eco.gov.yk.ca/application-process.html Applicant Signature:Date MM slash DD slash YYYY Section BreakUntitled First Choice Second Choice Third Choice Δ Angie WabiscaExecutive Assistant to the Chief867-456-6888 ext 331
