Online Registration Form
Here is where you can apply to Katimavik’s 2008-2009 program, a unique adventure during which you'll discover 3 Canadian regions with 10 other youth. This is a great opportunity to broaden your horizons, gain new skills and get out there for a change!
 
IMPORTANT : After you've filled out this short form, you’ll have to download, print, fill out and send us your candidate’s file.
 
Departure dates for the 2008-2009 program are in September and October (9-month program).
 
*Mandatory fields
Last name* Telephone home* -- ext.
First name* Cell phone --
E-mail address* Fax --
Gender*  
Birth date* --
Password:*
Repeat password:
 
Permanent address
Address*
City*
Province*
Postal code*
 
Click here if your mailing address is different from your permanent address.
 
I am a visible minority*
I am an aboriginal person*
Language of correspondence*
Mother tongue*
Information requested for statistical purposes only (your answers will not affect your application)
What is your current occupation?*
What is your family's approximate annual income?*
How many people depend on this income?*
What is the approximate population of your city / village?*
Where did your hear about Katimavik?*
Dates for Katimavik's 2008-2009 program. Please specify your availability.
From 17 September 2008 to 17 June 2009*  
From 24 September 2008 to 24 June 2009*  
From 15 October 2008 to 15 July 2009*  
From 22 October 2008 to 22 July 2009*  
 
For more information, call us at 1 888 525-1503 or e-mail us at selection@katimavik.org.
Thank you!