PCC Inc. registration form

How To Register

Please print this form and mail to:
420 Read Drive, Summerside, PE C1N 5A9

Some of the registration costs may be covered under government/community funding but you as the client and/or caregiver need to look into the funding sources. If you need any support on where to look for funding please contact our office at (902) 436-0005.

Now that you have your info and know what you can spend, please fill out the following:

I would like to register for the following Programs/Services:

1. ______________________________________________________

2. ______________________________________________________

3. ______________________________________________________

4. ______________________________________________________

5. ______________________________________________________

My Total Monthly Cost is $____________ .

Signed by: ________________________

Date: ______________

A 30-Day Notice Must Be Given To PCC Inc. in Regards To Any Participation/Program Changes For Each Client/Participant. Our fees are registration fees which means you must pay for the service you register for whether or not you attend (excluding travel fees).

Back