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  For youth from 2 to 18 years of age. This is a service for Dieppe and Memramcook residents. Applications are considered on a first come, first serve basis. Help to complete this application is available.
   
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  Two references - Please provide two references (other than family members) that are familiar with your family and financial situation. (Example: teacher, coach, social worker, neighbor, doctor or nurse.)
   
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  Personal information contained on this form is gathered under the authority provided by the Right to Information and Protection of Privacy Act and the Personal Health Information Privacy and Access Act. This personal information will be used for the child's registration in the P.R.O. Kids program. Contact the Office of the City Clerk of the City of Dieppe at 877.7900 for any questions regarding the collection of this data.
   
 
 
 
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