Request your nomination contestant package

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First Name*

Last Name*

Address*

City*

Province/Territory*

Postal Code*

Email*

Phone Number *

Date of Birth

Year*

month*

Day* Select year/month first

Please select the riding you wish to stand for nomination.

COMMISSIONS*

I am of Indigenous Ancestry

I identify as a woman

*(Other commissions determined by date of birth: Young Liberals and Seniors)

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