#103, 6030 – 88 St, Edmonton, AB T6E 6G4 Tel. 780-414-0249 Fax. 780-465-6801
APPLICATION FOR BIRD GAME OUTFITTER-GUIDE PERMIT
NAME (INDIVIDUAL OR REGISTERED COMPANY)
CORPORATE ACCESS #
NAME OF COMPANY CONTACT
DATE OF BIRTH (YYMMDD)
ADDRESS
CITY/TOWN
POSTAL CODE
BUSINESS PHONE #
RESIDENT PHONE #
CELL #
EMAIL ADDRESS
FAX #
WEB SITE
Holds Commercial General Liability Insurance and Deposit Protection through the APOS group plan YES  NO 
I If not, provide proof of $5,000,000 coverage and $10,000 Deposit Protection for Outfitted Hunting in AB
(INDIVIDUAL OR SHAREHOLDER OF REGISTERED COMPANY)
Are you a Canadian citizen or admitted to permanent residency in Canada?
 Yes
 No
Other
Are you 18 years of age or older?  Yes
 No
Current Guide Designation #
Wildlife Identification Number
Your personal information is collected by APOS in accordance with the Wildlife Act Regulations, the Alberta FOIP Act and APOS Bylaws
I hereby acknowledge that I personally or my Registered Company meets all the conditions of employment
in Canada.
____________________________________________________________________
_______________________________
Signature of Individual or Shareholder of Registered Company
Permit Cost: Bird Game Outfitter-Guide ONLY
Bird Game with Class S or T Outfitter-Guide Permit
$262.50 (Includes GST)
$131.25 (Includes GST)
Date