Operator Child Care Allowance Program Expense Form

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Personal Information on this form is collected pursuant to section 31(c) of the Freedom of Information and Protection of Privacy Act, RSPEI 1988, c F-15.01 as it relates directly to and is necessary for the provision of calculating the Child Care Allowance and will determine the eligible amount for reimbursement. If you have questions about this collection of personal information, you may contact Early Childhood Services at 902-368-4733.

Identification

Enter the name and information for the licensed centre in the fields below.

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

License Number