Mail ballot request form

Applications for mail ballots must be submitted no later than 2:00 p.m. on general voting day (Saturday, April 12, 2025).

If your application is complete and you qualify to vote by mail ballot, a mail ballot package will be sent to you as soon as the ballots are available. If we receive your application after 9:00 a.m. on Thursday, March 27, 2025, the time may be insufficient for mailing and receipt of the ballot; we recommend that you arrange to pick up your mail ballot package from the North Cowichan Municipal Hall. The estimated date that mail ballot packages will be available is between Monday, March 24, 2025 and Friday, April 11, 2025 (either by Canada Post standard mail service or pick up at the Municipal Hall).

You are responsible for ensuring that your completed ballot and documents are received by the chief election officer before the close of voting at 8 p.m. on Saturday, April 12, 2025 (general voting day).

If your name is not on the Register of Resident Electors, you will be required to provide two (2) pieces of identification when you deliver your ballot.

Freedom of Information and Protection of Privacy Act Notice
Personal information contained on this form is collected under the Freedom of Information and Protection of Privacy Act sections 26(a) and 26(c) and will be used only for the purpose of the mail ballot voting process for the 2025 by-election pursuant to the Local Government Act section 110. If you have any questions about the collection and use of this information, please contact the Chief Election Officer or Deputy Chief Election Officer, District of North Cowichan, 250-746-3131.

Name of applicant

First name

Middle name

Last name

Residential address

Street number and name

City/Town

Province

Postal Code

Mailing Address (if different from above)

Street name and number

City/Town

Province

Postal Code

Phone number (daytime)

Email address

I am applying as a:

(choose only one)

Resident elector

Non-resident property elector

If you are a non-resident property elector, provide the full address of the real property in relation to which you are voting (otherwise leave this blank):

I request that my mail ballot package be:

(check only one)

Mailed to my residential address

Mailed to the following address:

Kept at Municipal Hall for me to pick up

Kept at North Cowichan Municipal Hall for the following person to pick up:

By submitting this application, I DECLARE THAT I AM:

18 years of age or older on general voting day (Saturday, April 12, 2025); and
a Canadian citizen; and
a resident of British Columbia for at least six months immediately before the day of voter registration; and
a resident of North Cowichan OR a non-resident owner of real property in the Municipality of North Cowichan for at least 30 days immediately before the day of voter registration; and,
not disqualified by law from voting in an election or otherwise disqualified by law.