Actuel Page 1 Page 2 Page 3 Aperçu Personal information on this form is collected under Section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c f-15.01 as it relates directly to and is necessary for determining eligibility. If you have any questions about this collection of personal information, you may contact the Innovation PEI Office by telephone at 1-800-563-3734 or by email at innovation@gov.pe.ca. Identification Provide the mailing address of the business or organization in the fields below. Nom de l’entreprise/organisation Prénom de la personne-ressource Nom de la personne-ressource Adresse 1 Adresse 2 Ville, municipalité, communauté Province Code postal Exemple : C1B 0X1 ou 12345 Pays Téléphone 1 Exemple : 902-555-5555 Téléphone 2 Exemple : 902-555-5555 Télécopieur Exemple : 902-555-5555 Adresse courriel Business Development Region - Sélectionner -Kings CountyQueens CountyPrince County Business Website Is the civic address different than the mailing address entered above? - Sélectionner -YesNo Civic Address Address City, Town, or Community Province Postal Code Example: C1B 0X1 or 12345