* = Required
Voter Registration
Name
Last Name*
First Name *
Middle Name
Date of Birth
Day*
Month*
Year*
Gender*
Contact
Email*
Details
Occupancy Status*
Roman Catholic*
French Language Rights*
Residency Status*
School Support*

Property Address
Street Number*
Street Number Suffix
Street Name*
Street Type
Street Direction

Mailing Address
Address 1*
Address 2
Address 3
City*
Province*
Country*
Postal Code*




  

This information is collected under authority of s. 17, s. 24 and s. 25 of the Municipal Elections Act, 1996 and s. 15 and s. 16 of the Assessment Act and will be used to determine voter eligibility.