This is a new registration / an update

Business Name:
Mailing Address:
Community:
Postal Code:
Street Address (if different):

Contact Person:
Area Code & Telephone Number:
Area Code & Fax Number:
E-mail address:
Web-Site:
Please provide a short description (25 words or less) of your services:

Please select the options below that best describe your business. Selections can be made in each category, but please restrict the total to a maximum of 12 fields. To make a selection of more than one (1) field in each category,
hold down the "CTRL" key and click the applicable fields with your mouse.

Consultant Fields:

Service Supplier Fields:

Building Construction & Services Fields:

Road & Municipal Construction Services Fields:

Suppliers of Goods:

Business Licence #:

Business Category:

Yukon Business
I certify that this business
meets / does not meet
the definition of a Yukon Business as defined in the Contract Regulations and Contracting Directive.

Full Name of Individual making confirmation:

Position in Business: