Customer Personal Information Address (where the project will be implemented) Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Project manager (if different from customer) I understand that the personal information provided when filling out the online form is only used and necessary to receive Gazifère’s services, to participate in the programs, or to respond to my enquiry, and in accordance to Gazifère’s privacy policy. 71534