Elementor #1247 - Niiwin Wendaanimok

- Step 1 of 2

Registration

Name *

First

Last

Please provide your full name

Community *

Please select your community.

Community Name

Please provide the name of your community.

Registration Type *

Job Seeker
Own or Operate Business
Own or Operate Equipment
None of the above.

Please select all that apply. Your selection will determine what questions will follow.

Contact Information

Phone

Please provide your Phone Number

Please provide your Email Address

Do you have a Facebook page?

If you select "Yes" we may add you on Facebook. in order to communicate with you.

How can we find you on Facebook?

Please enter your Facebook URL, user name, or the name you go by on Facebook (if it is not the same as the name you provided in the Registration section above).

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

What is the best way to contact you? *

Phone
Email
Facebook
Other

What other way can we contact you?

You said "Other" in the question above. How else would you like us to contact you?

Employment Profile

Primary Occupation or Service *

Select your occupation

State your Primary Occupation or Service

You indicated "Other" for the question above. Please state your main occupation or service you provide.

Licensing or Certification for Primary Occupation or Service

Please state what licensing or certification you have for your primary occupation or service you provide.

Formal Training for Primary Occupation or Service

Please state or describe any formal training you have completed or are in the process of completing for your primary occupation or service.

Years of Experience in your Primary Occupation *

Please state your number of years of experience in your primary occupation or service.

Add a Secondary Occupation, Profession, or Service? *

Would you like to add a secondary occupation or service?

Secondary Occupation, Profession, or Service

Select your secondary occupation or service.

State your Secondary Occupation, Profession, or Service

You indicated "Other" for the question above. Please state your secondary occupation or service.

Licensing or Certification for Secondary Occupation or Service

Please state what licensing or certification you have for your secondary occupation or service.

Formal Training for Secondary Occupation or Service

Please state or describe any formal training you have for your secondary occupation or service.

Years of Experience for Secondary Occupation *

Please state your number of years of experience in your secondary occupation or service.

Submit Resume

Click or drag files to this area to upload. You can upload up to 2 files.

You are strongly encouraged to submit a current resume if you have one available.

Business Registration

Business Name *

What is the name of the business you'd like to have added to the Resource Inventory?

Business Description *

Please describe your business. What services does it provide? What product does it sell?

Business Owner *

Please state the name of the business owner.

Number of Employees *

Please indicate the number of employees at this business.

Equipment Registration

Number of pieces of equipment to register *

Select the number of pieces of equipment you'd like to register. If you need to register more than five pieces of equipment, please contact aluby@niiwinwendaanimok.com

Equipment #1

Equipment (1) *

Please describe the piece of equipment you'd like to register. Include any details that you feel may be relevant to the equipment.

Equipment Owner (1) *

Please state the name of the Equipment Owner. If the owner is a business, please state the name of the business.

Equipment Operator(s) (1) *

Please list the name(s) of all operators of this equipment (including the owner if they are also an operator).

Equipment Year (1)

Please state the year that the equipment was built / released.

Equipment Make (1)

Please indicate the make of the equipment.

Equipment Model (1)

Please indicate the model of the equipment.

Equipment Readiness (1) *

Please indicate the readiness of the equipment for work.

Equipment #2

Equipment (2) *

Please describe the piece of equipment you'd like to register. Include any details that you feel may be relevant to the equipment.

Equipment Owner (2) *

Please state the name of the Equipment Owner. If the owner is a business, please state the name of the business.

Equipment Operator(s) (2) *

Please list the name(s) of all operators of this equipment (including the owner if they are also an operator).

Equipment Year (2)

Please state the year that the equipment was built / released.

Equipment Make (2)

Please indicate the make of the equipment.

Equipment Model (2)

Please indicate the model of the equipment.

Equipment Readiness (2) *

Please indicate the readiness of the equipment for work.

Equipment #3

Equipment (3) *

Please describe the piece of equipment you'd like to register. Include any details that you feel may be relevant to the equipment.

Equipment Owner (3) *

Please state the name of the Equipment Owner. If the owner is a business, please state the name of the business.

Equipment Operator(s) (3) *

Please list the name(s) of all operators of this equipment (including the owner if they are also an operator).

Equipment Year (3)

Please state the year that the equipment was built / released.

Equipment Make (3)

Please indicate the make of the equipment.

Equipment Model (3)

Please indicate the model of the equipment.

Equipment Readiness (3) *

Please indicate the readiness of the equipment for work.

Equipment #4

Equipment (4) *

Please describe the piece of equipment you'd like to register. Include any details that you feel may be relevant to the equipment.

Equipment Owner (4) *

Please state the name of the Equipment Owner. If the owner is a business, please state the name of the business.

Equipment Operator(s) (4) *

Please list the name(s) of all operators of this equipment (including the owner if they are also an operator).

Equipment Year (4)

Please state the year that the equipment was built / released.

Equipment Make (4)

Please indicate the make of the equipment.

Equipment Model (4)

Please indicate the model of the equipment.

Equipment Readiness (4) *

Please indicate the readiness of the equipment for work.

Equipment #5)

Equipment (5) *

Please describe the piece of equipment you'd like to register. Include any details that you feel may be relevant to the equipment.

Equipment Owner (5) *

Please state the name of the Equipment Owner. If the owner is a business, please state the name of the business.

Equipment Operator(s) (5) *

Please list the name(s) of all operators of this equipment (including the owner if they are also an operator).

Equipment Year (5)

Please state the year that the equipment was built / released.

Equipment Make (5)

Please indicate the make of the equipment.

Equipment Model (5)

Please indicate the model of the equipment.

Equipment Readiness (5) *

Please indicate the readiness of the equipment for work.

Registration

Contact Information

Employment Profile

Business Registration

Equipment Registration

Equipment #1

Equipment #2

Equipment #3

Equipment #4

Equipment #5)

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