YKDFN Evacuee Registration

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YKDFN is working hard to cater to its members. Please enter your information below so that we know that you are safe and we can reach you for urgent messaging.

This form MUST be filled out for each person, regardless of age. Each YKDFN members please complete once.

Full Name *

Email *

Phone number *

Date of birth *

YYYY

Are you a YKDFN member? *

Please provide your status number, if available.

Current location *

Calgary, AB

Edmonton, AB

Fox Creek, AB

Grande Prairie, AB

High Level, AB

Lac La Biche, AB

Red Deer, AB

Valleyview, AB

Whitecourt, AB

Winnipeg, MB

Other:

Are you in an evacuee centre, hotel or private accommodations? *

Evacuee Centre

Hotel (provided by evacuee registration)

Private accommodations (hotel or with friends/family)

Other:

If possible, please provide the address where you are staying.

Have you registered with the GNWT as an evacuee? *

Are you in need of financial assistance? *

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