Forms

SCIS Card Applications Forms (Current Members)

Secure Certificate of Indian Status *Added October 12, 2020
Registration-SCIS Guarantor Declaration
SCIS Instruction Booklet

Change of address

SCIS CLERK
Betty Lou Hynes
709-634-8675
bhynes@qalipu.ca

Indian Registration Administration (New Registrations)

Adult Registration-SCIS Application
Instruction Booklet for Adult Registration-SCIS Application

Child (15 and Under) Registration-SCIS Application
Instruction Booklet for Child Registration-SCIS Application

Registration-SCIS Guarantor Declaration

If you have any trouble completing these forms, please contact the Indian Registration Administrator, Nancy O’Connell, at 709-634-4010 or 1-855-263-6440 (toll free in Newfoundland only). You may also email Nancy at noconnell@qalipu.ca

Non-Insured Health Benefits Forms

List of Approved Mental Health Providers (PDF)
Health Canada Client Reimbursement Form (For pharmacy, medical supplies / equipment, dental, & vision) (PDF) *Updated April, 2022
Qalipu Medical Transportation Reimbursement Form (For medical related travel expense claims) (PDF) *Updated May, 2024
Qalipu Medical Transportation Reimbursement Form Guideline (PDF) *Updated May, 2022
Client EFT Direct Deposit Form (PDF) *Updated November 29, 2021
Vendor EFT Direct Deposit Form (PDF) *Added November 2, 2018

Forms

SCIS Card Applications Forms (Current Members)

Indian Registration Administration (New Registrations)

Non-Insured Health Benefits Forms

Housing Forms

Jordan’s Principle Forms

The Education and Training Department