Current Page 1 Page 2 Preview Information contained in and collected in relation to this Agreement is subject to, and will be treated in accordance with, the Prince Edward Island Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, Cap. F-15.01 (the "FOIPP Act"). Any information provided in respect of this Agreement may be subject to release under the FOIPP Act. The amount of the Contribution may be disclosed at the discretion of Innovation PEI and in accordance with the FOIPP 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 Cell Phone Number For example 902-555-5555 County - Select -PrinceQueensKings Is the civic address/location of this project different from the address above? - Select -YesNo Civic Address Address City, Town or Community Postal Code For example C1B 0X0 or 12345 Applying as: - Select -Property OwnerLeaseholder with Approval from the Property Owner Are you a full-time permanent resident of PEI? - Select -YesNo You may not be eligible for this program. Review guidelines at the PEI Broadband Fund for Residents.