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* 1. Are you a Yak-tat Kwaan Shareholder?

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* 2. If no, are you a shareholder descendant?

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* 3. If you are a shareholder descendant, have shares gifted but are currently pending processing at the Corporation? (This includes estates that your family has submitted all the documentation for).

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* 4. First Name

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* 5. Last Name

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* 6. Other names used or name currently on file with Yak-tat Kwaan

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* 7. How many Yak-Tat Kwaan shares do you currently have? (Please note the coalition is unable to help you determine number of shares. You will have to contact the Yak-tat Kwaan directly to inquire).

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* 8. Email address

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* 9. Phone number (please indicate if this a cell/mobile phone capable of receiving SMS text messages)

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* 10. When a Recall Petition for the current board directors becomes available, would you like to sign?

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