Apply to the Senior's Independence Initiative

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Personal information on this form is collected under Section 31 (c) of the Freedom of Information and Protection of Privacy Act and will be used for administering the Social Assistance Act or the Supports for Persons with Disabilities Act. If you have any questions about this collection of personal information, you may contact the Manager of Administration, Social Programs, Department of Social Development & Housing, 902-368-5230.

For example C1B 0X1 or 12345
For example 902-555-5555
Spouse Information