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Prince Edward Island
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Assurance Systems Program
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Identification
Wha sub-program program are you applying to?
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On-Farm Assurance Sub-Program
Post-Farm Assurance Sub-Program
Surveillance and Emergency Management Sub-Program
First Name
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Middle Initial
Last Name
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Address 1
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Address 2
City, Town or Community
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Province
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Postal Code
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For example: C1B 0X1 or 12345
Country
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Telephone Number
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For example 902-555-5555
Email Address
Cell Phone Number
For example 902-555-5555
Fax Number
For example 902-555-5555
Preferred Method of Communication
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Cellular phone
Email
SMS text message
Telephone
Other
Other
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Organization Information
Organization Name
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Organization's Twitter Account
Type of Organization
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Incorporated Company (if you file to Canada Revenue Agency as a corporation)
Individual Proprietorship (if you file to Canada Revenue Agency as an individual)
Partnership (if you file to Canada Revenue Agency as a partnership)
Registered Charitable Organization / Not for Profit
Other
Partnerships
Partner Name
Percentage of Ownership
Partner Name
Percentage of Ownership
Add a row
Revenue Canada Business Number
Charity Registration Number
Social Insurance Number
Registration Number
I am applying as
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Indigenous government/indigenous community/indigenous group
Municipal government
Primary producer
Processor
Processor organization
Producer organization
Provincial/Territorial government
Research body (ie, university, hospital, research institute, information institute, etc.)
Retailer/Wholesaler/Input supplier
Other industry organization (ie, associations, agri-service provider)
Other Industry Organization
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Type of Industry
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Agricultural, construction and mining machinery manufacturing
Animal food manufacturing
Bakeries and tortilla manufacturing
Beverage manufacturing
Cattle ranching and farming
Dairy product manufacturing
Farm product merchant wholesalers
Fiber, yarn and thread mills
Food and beverage stores
Food, beverage and tobacco merchant wholesalers
Forest nurseries and gathering of forest products
Fruit and tree nut farming
Fruit and vegetable preserving and specialty food
Grain and oilseed milling
Greenhouse, nursery and floriculture production
Hog and pig farming
Meat product manufacturing
Multiple industries
Oilseed and grain farming
Other animal protection
Other crop farming
Other food manufacturing
Poultry and egg production
Professional, scientific and technical services
Seafood product preparation and packaging
Sheep and goat farming
Support activities for animal production
Support activities for crop production
Vegetable and melon farming
Multiple Industries
Other Animal Production
Other Crop Farming
Other Food Manufacturing
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