PEI Broadband Residential Inquiry Form

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Identification
Provide the civic address where Internet service will be improved.
For example C1B 0X1 or 12345
For example 902-555-5555
For example 902-555-5555
(1,000 character limit)
Acceptance

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. The amount of the Contribution may be disclosed at the discretion of Innovation PEI and in accordance with the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, Cap. F-15.01. 

Personal information on this form is collected under Section 31(c) of the Freedom of Information and Protection of Privacy Act and is necessary to determine your suitability and/or eligibility for programs delivered by Innovation PEI. If you have any questions about this collection of personal information, you may contact Innovation PEI by  telephone: 902-368-4669 or email: myinternet@gov.pe.ca.

1 + 3 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.