Apply for Your New Civic Address

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Your personal information is collected on this form under section 31(c) of the Freedom of Information and Protection of Privacy Act and will be used only for assigning a civic address by the 911 Administration Office under the provision of the Emergency 911 Act.

Identification

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

Business Name

Business Telephone Number

Are you the landowner?

Landowner Information

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

Business Name