Required fields are marked with asterisks (*)

Notice of Intent to Run

An individual intending to run for Mayor or Council must submit this form to the Election Office before accepting campaign contributions or incurring campaign expenses as set out in Part 5.1 Election Finances and Contributions Disclosure of the Local Authorities Election Act.

Please notify the Election Office if there are any changes to the information below by emailing elections@camrose.ca.

I am intending to run for

Mayor

Council

Full Name

Full Address

City

Province

Postal Code

Phone Number (Campaign Office)

Phone Number (other)

Email Address

Address of place(s) where candidate records are maintained (records must be kept for a period of three years following election day)

Address of place(s) where communications may be sent

Name of the financial institution where campaign contributions will be deposited

Address of the financial institution where campaign contributions will be deposited

Name(s) of signing authorities for the above depository

Name of an additional financial institution where campaign contributions will be deposited

Address of an additional financial institution where campaign contributions will be deposited

Name(s) of signing authorities for the above depository

Name of an additional financial institution where campaign contributions will be deposited

Address of an additional financial institution where campaign contributions will be deposited

Name(s) of signing authorities for the above depository

Signature (if on a computer, use your mouse or if on a tablet or phone, use your finger to sign your signature)

Clear

Date

By using the Signature box above, you are indicating that the information entered in this form is accurate.

Personal information is collected under the authority of s. 33(a) and (c) of the Freedom of Information and Protection of Privacy Act and will be used in the management and administration of the local election. This form may be disclosed as allowed or required by law. If you have any questions about the collection, use and protection of this information, please contact the FOIP Coordinator at (780) 672-4426.