2. Thank you for your interest in voting in the 2022 General Local Election and Regional Assent Voting.

   • All applications will be reviewed for eligibility.
   • Ballot packages will be: mailed to those eligible; OR held for pick-up by authorized individuals once the ballots have been printed.
   • Ballots must be returned to the CVRD Office at 175 Ingram Street, Duncan, BC, V9L 1N8, no later than 8:00 pm,
   on Saturday, October 15, 2022.

   
   
4. First Name*
6. Last Name*
8. I am applying to vote by mail as a:*

   1. Resident Elector; OR
   2. Non-Resident Property Elector

10. **Note to Non-Resident Property Owners: Have you already registered as a Non-Resident Property Elector? If not, please contact the CVRD Elections Assistant at 250-746-2574 or 1-800-665-3955 (Ext. 2574), or email: elections@cvrd.bc.ca If you have already registered, you may proceed with submitting this application form.
    
    
12. The address of my residence OR the legal description (including PID) of my property is:*
14. 
    

    I request a ballot to vote by mail for the 2022 General Local Election and/or Regional Assent Voting in relation to Regionally Significant Recreation Facilities Funding Establishment Bylaw No. 4438, to be held on Saturday, October 15, 2022.

    I am eligible to vote as I am:*

    1. 18 years of age or older on October 15, 2022; and
    2. a Canadian citizen; and
    3. a resident of BC for at least the past 6 months; and
    4. a resident living within the boundaries of the Cowichan Valley Regional District OR a non-resident registered owner of real property located within the boundaries of the CVRD; and
    5. not disqualified by law from voting in an election or otherwise disqualified by law.
16. I request that a mail ballot package be delivered to the address noted below:
18. Applicant Mailing Information
20. Address
22. City
23. Province
24. Postal Code
26. Telephone Number
27. Email
29. OR, I request that the mail ballot package be made available for pickup by myself OR by the individual whom I have authorized and is listed below:
31. First Name
32. Last Name
34. 
    Contact Information of Authorized Individual OR same as above
    
36. Phone:
38. Email:
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field