Current Page 1 Page 2 Page 3 Preview The information collected on this form will be used for licensing under the Early Learning and Child Care Act and Regulations. The information is collected under the authority of the Early Learning and Child Care Board and managed in accordance with the Freedom of Information and Protection of Privacy Act. If you have any question about the collection, use or disclosure of your personal information, please contact the Early Learning and Child Care Board, 902-368-6513. 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 What category of licence are you renewing? - Select -Early Childhood CentreFamily Home CentrePre-school CentreSchool-age Child Centre How does your centre's governance currently operate? - Select -Private OwnerPartnershipCorporation Private Owner Private Owner Address 1 Address 2 Are you registered with Corporate/Business Names Registry? - Select -YesNo Partnership Partnership First Name Last Name Address Legal Status Item weight Add more items more items Corporation Officer Information Officer Information First Name Last Name Address Legal Status Item weight Add more items more items