Please print following page, and mail the completed application to :

BLOCK PARENT PROGRAM OF WINNIPEG, INC.
466 GERTRUDE AVENUE
WINNIPEG, MANITOBA
R3L 0M8

Depending on your connection speed, this make take a few minutes. When the application form appears, click on the word "File" at the upper left hand corner, and then click on "Print". This will print the application on your printer.

And thank you for your interest in making our city a safer place.

The application is in PDF format.

Click here for a free copy of Adobe Reader

Click here for the printable application

PLEASE NOTE THAT DUE ALL APPLICANTS MUST ALSO HAVE A C.A.R. (Child Abuse Registry) SCREENING. INFORMATION AND APPLICATION FORMS WILL BE PROVIDED TO YOU ONCE YOUR APPLICATION FOR BLOCK PARENT MEMBERSHIP IS RECEIVED. PLEASE CONTACT THE BLOCK PARENT OFFICE FOR MORE INFORMATION.

For more information on becoming a Block Parent call 284-7562

Please follow this LINK for information on the Personal Information Protection and Electronic Documents Act and the Block Parent Program of Winnipeg Inc.