Current Page 1 Page 2 Preview Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act for program administration purposes. Questions regarding the collection or use of this information can be referred to the program coordinator at 902-620-3226. Identification Enter the group name (i.e. low income, seniors, non-profit, student, etc) in business/organization field, if applicable. 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 Registered Charity Number