Tahltan Nation Member Contact Update Form

Please provide the information below if:
You have already submitted a Tahltan Nation Member Information Form and you have:

Moved
Changed your email address
Changed your phone number
Changed your legal name
Someone in your immediate or extended family has passed away

Previous Legal Name (Suffix examples: Jr, Sr, III)*

Prefix (optional)

First Name

Middle Name (optional)

Last Name

Suffix (optional)

Here are some prefix examples: Dr., Mr., Mrs., Ms. (For instance Dr. John Smith)
Here are some suffix examples: Jr, Sr, III (For instance John Smith III)

New Legal Name*

Prefix (optional)

First Name

Middle Name (optional)

Last Name

Suffix (optional)

Gender*

Please select one

New (or current) Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Please list all household members at the new address

Separate by comma or line break. And please include their full legal name.

New (or current) Home Phone Number

Please include area code

New (or current) Mobile Phone Number

Please include area code

New (or current) Email Address

Or current

How would you like to receive information from the Tahltan Central Government? *

Email Canada Post Phone Text I don't want to receive information

Other:

Additional Information/Comments