Elite Athlete Assistance Program

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Prefill with your MyPEI Account

Allow this form to use information already in your MyPEI account to fill in fields automatically. You can review and edit everything before submitting.

Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c.F-15-01 as it relates directly to and is necessary for the Elite Athlete Assistance Program, and will be used to administer this program. If you have any questions about this collection of personal information, you may contact Margie Misener at mrmisener@gov.pe.ca. Information may be verified.

Identification

Enter the athlete's information in the fields below.

Is the athlete 18 years of age or older?

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

First Name

Middle Initial

Last Name

Date of Birth

Gender

Sport

Have you been a resident of Prince Edward Island for a minimum of six months?

Parent/Guardian Information

If athlete is under 18 years of age please provide parent or guardian contact information below.

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address