Apply to Volunteer with Health PEI Long-term Care

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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 R.S.P.E.I. 1988, c.F-15-01 as it relates directly to and is necessary for the Volunteer with Health PEI Long-term Care Program, and will be used for the purposes of assessing volunteer applications. If you have any questions about this collection of personal information, you may contact Administrative Support at 902-368-5826. Information may be verified.

Identification
For example C1B 0X1 or 12345
For example 902-555-5555
Emergency Contact Information