Current Page 1 Page 2 Page 3 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 at 902-393-3325. Identification 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 How will your Family Home Centre's governance operate? - Select -Private OwnerPartnershipCorporation Private Owner First Name Last Name Partnership Partners Partners First Name Last Name Address City, Town, or Community Province Item weight Add more partner more partner Legal Status Corporation Officer Information Officer Information First Name Last Name Address City, Town, or Community Province Item weight Add more officer more officer Legal Status