A-367 Nunavut Cannabis Retailer Application Form Download Form PDF Nunavut Cannabis Retailer Application Form Under the Cannabis Act (Nunavut), the undersigned entity is applying for a licence to retail cannabis in Nunavut. Contact Information Applicant Name ᐃᕐᖐᓈᖅᑕᐅᑦ ᐅᖄᓚᐅᑖ Mailing Address City/Town - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon State/Province ZIP/Postal Code Business Information Business Name Head Office Mailing Address City/Town - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon State/Province ZIP/Postal Code Business Structure (select one) Corporation Partnership Sole Proprietor Company Other: Enter other… Personal Information of all Business Partners/Equity Participants Name Address Email Phone Date of Birth Shares Held Name Address Email Phone Date of Birth Shares Held Name Address Email Phone Date of Birth Shares Held Name Address Email Phone Date of Birth Shares Held Name Address Email Phone Date of Birth Shares Held Name Address Email Phone Date of Birth Shares Held ᖃᓄᐃᓕᐅᒐᒃᓴᐃᑦ Current Nunavut Cannabis Retailer Application Form Cannabis Store Information Document Checklist (check all documents that have been included with this application) Declaration Preview Complete ᐅᓇ ᒪᒃᐱᖅᑐᒐᖅ ᐊᑑᑎᕚ? ᐄ ᐋᒃᑲ Provide comments IU ᐃᕐᖐᓐᓈᖅᑕᐅᑦ ᐊᑐᐃᓐᓇᐅᑎᑦᑎᓗᑎᑦ ᐅᖃᐅᓯᐅᔪᒥᒃ? ᖁᔭᓐᓇᒦᒃ ᖃᐅᔨᒋᐊᕋᕕᑦ ᓄᓇᕗᒻᒥ ᒐᕙᒪᒃᑯᓐᓄᑦ ᓇᒃᓯᐅᔾᔨᑦᑕᐃᓕᒋᑦ ᐊᒃᑐᖅᑕᐅᓴᕋᐃᑦᑐᓂᒃ ᓇᖕᒥᓂᕐᓘᓐᓃᑦ ᓇᓗᓇᐃᔭᐅᑎᓂᒃ, ᐃᓚᐅᓗᑎᒃ (ᑭᓯᐊᓂ ᐃᓱᓕᕝᕕᖃᙱᑦᑐᖅ): ᓴᓇᔪᓐᓇᐅᑎᑦ ᓈᓴᐅᑎᖏᑦ, ᐃᓅᕝᕕᖏᑕ, ᓇᓗᓇᐃᔭᐅᑎᖏᑦ ᐊᓯᖏᑕ ᐃᓄᐃᑦ, ᐋᓐᓂᐊᖃᕐᓇᙱᑦᑐᓕᕆᓂᕐᒧᓪᓘᓐᓃᑦ ᓇᓗᓇᐃᔭᐅᑎᑦ. ᓇᐃᑦᑐᒥᒃ ᐅᓂᒃᑳᖅᓯᒪᔪᒥᒃ ᓇᒃᓯᐅᔾᔨᑐᐃᓐᓇᕐᓂᐊᖅᐳᑎᑦ ᐱᔾᔪᑎᒥᒃ ᐃᓱᒫᓘᑎᒋᔭᕐᓂᒡᓘᓐᓃᑦ ᖃᓄᕐᓗ ᐃᓕᖕᓄᑦ ᖃᐅᔨᒋᐊᕈᓐᓇᕐᒪᖔᑦᑕ. ᖃᐅᔨᒪᒋᐊᕐᓂᐊᖅᐳᒍᑦ ᑕᐃᓐᓇᑦᑎᐊᖅ ᐃᓄᒃ ᖃᐅᔨᒋᐊᕐᕕᒋᓗᓂᑎᑦ ᑐᑭᓯᒃᑲᓐᓂᕆᐊᕆᐊᖃᖅᐸᑕ ᐅᕝᕙᓘᓐᓃᑦ ᑭᐅᔪᓐᓇᕐᒪᖔᑦ ᐊᐱᖅᑯᑎᖕᓂᒃ ᐃᓱᒫᓘᑎᒋᔭᕐᓂᒡᓘᓐᓃᑦ.
