Current Page 1 Page 2 Preview Personal information on this form is collected under Section 31(c) of Prince Edward Island’s Freedom of Information and Protection of Privacy Act and will be used to determine and verify, in conjunction with other supporting documents, applicant eligibility for grant programs as well as statistical information. If you have any questions about this collection of personal information you may contact Doreen Gillis, Director, Early Childhood Development at 902-368-4733. Identification What stream(s) of the Family Home Capital Grant are you applying to? Capital Improvements Stream Family Home Centre Program Improvements Stream Infant Programming Equipment Stream I am applying to all streams of the Family Home Capital Grant. Business/Organization Name Contact First Name Contact Last Name Address 1 Address 2 City, Town, or Community Province Postal Code For example C1B 0X1 or 12345 Country Telephone 1 For example 902-555-5555 Telephone 2 For example 902-555-5555 Fax Number For example 902-555-5555 Email Address Family Home Centre License Number Is the mailing address different from above? - Select -YesNo Mailing Address Address City, Town, or Community Province Postal Code Example: C1B 0X1 or 12345