Voter Registration Form Name*Please enter your name as it is listed on your driver's license, Manitoba Enhanced Identification Card, and/or other official government documents.Date of Birth* Date Format: MM slash DD slash YYYY Phone Number*We may need to contact you to confirm details of your registration. Please provide a phone number that you can be reached at. Mailing Address* Street Address Address Line 2 City ManitobaAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Civic Address of Altona Property*In order to be eligible to vote in Altona, you must be a resident of Altona for at least six months prior to the election date, or a registered owner of land in Altona for at least six months prior to the election date. Please enter your civic address. Apartment #House #Street Name, Type, Quadrant Voter Eligibility Declaration*By submitting this form, I declare that as of October 14, 2020, I am: at least 18 years old a Canadian citizen a resident of Altona for at least six months OR a registered owner of land in Altona for at least six months NameThis field is for validation purposes and should be left unchanged.