Required fields are marked with asterisks (*)

Child Care Space Incentive Policy Application

Please complete all required fields and ensure your application is complete prior to submission. For questions on this incentive, please email incentives@coldlake.com.

Section 1: Applicant Information

Business Owner's Full Name

Mailing Address

Primary Phone Number

Primary Email Address

Section 2: Business Information

Business Name

Operating as (if different)

Business Address (if different than primary mailing address)

Business Phone Number

Business E-Mail Address

Business License #

Section 3: Project Information

Breifly describe your project and hot it meets the objects of this policy

What other municipal, provincial or federal funding sources have you received?

Section 4: Project Checklist

My business/organization is planning to maintain the new licenced childcare spaces for at least 10 years.

Yes

My business or organization is prepared to enter into a Childcare Space Incentive Program funding agreement with the City of Cold Lake.

Yes

My company or organization is in good standing with Alberta Corporate Registry.

Yes

My company or organization is in good standing with the City of Cold Lake.

Yes

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Protection of Privacy Act, Sec. 4 (c), which regulates the collection, use, and disclosure of personal information.

If you have any questions or concerns, please contact the ATI Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.