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 to register sites for the Nursing Summer Student Employment Program. If you have any questions about this collection of personal information, please call the Recruitment and Retention Secretariat at 902-620-3760. 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 Supervisor Information Provide contact details for the students' immediate supervisor if different than above. First Name Last Name Telephone Number For example 902-555-5555 Email Address