GeoConnections “Who are you” form

NStQ Stewardship Portal Access Request Form
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New users of the NStQ Stewardship Portal are required to complete the Portal Access Request
Form “Answer” column on this form and email it to the NStQ Portal Administrator
([email protected]) to request a user ID.
Please ensure that you provide a daytime contact number so that your user ID and password can
be obtained. For security reasons, passwords will only be provided over the phone.
User IDs and passwords are for individual use only and are not to be shared.
Question
First Name:
Last Name:
Daytime Telephone #:
Email Address:
User Group:
Job Title / Position:
Industry
Government:

If yes please identify
which Ministry & Office
Comments:
Answer
Examples
e.g. Elliot
e.g. Gleave
e.g. 123-456-7890
e.g. [email protected]
 Stswecem’c Xgat’tem
 Xats’ull
 T’exelc
 Tsq’escen’
 Tolko
 West Fraser
 Applicant
 Forester
 GIS Analyst
 NStQ Chief / Councilor
 NStQ Member
e.g. mining, forestry, ranching, etc.
 No
 Yes
e.g. “Min. of Forests – Chilcotin District”
or “BCTimber Sales - Central Cariboo
District”
Please record any additional information
you feel would be helpful to the
administrator.