Apply to Vote by Mail
Application for Registration and Special Ballot (For Canadian electors residing outside Canada) (EC 78500-X)

If you do not wish to submit your application at this time, you can download and print it. To do so, please click on the following link: Application for Registration and special ballot -- international elector (PDF form).

If you need any help, click here for instructions (opens in new window).

Indicates mandatory field

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Contact information

Given name

Middle Name(s)

Family Name

Primary phone number

Secondary phone number

Gender

Male
Female

Date of Birth

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900

Language of preference for communicating with Elections Canada

English
French

Email address

(format: abc@abc.abc)

Confirm your email address

(format: abc@abc.abc)

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Your Canadian Address for Voting Purposes

This address determines your electoral district. Click here for instructions (opens in a new window).

Unit/Apartment number

Number and Street, or Lot and Concession, or Township and Range

City, Town, Village or Municipality

Province or Territory Please Select... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

Postal Code

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Present Mailing Address

The mailing address where you want to receive your special ballot voting kit.

Number and Street, Apt. or Unit, Rural Route (RR), Post Office (PO) Box or General Delivery (GD)

City, Town, Village or Municipality

Province/Territory/State

Country

Postal Code / ZIP code

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Date You Left Canada and Date You Intend to Return to Canada

Date You Left Canada

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900

I intend to return to live in Canada by

Month January February March April May June July August September October November December Year 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050 2051 2052 2053 2054 2055 2056 2057 2058 2059 2060 2061 2062 2063 2064 2065 2066 2067 2068 2069

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Exemption to Five-Year Limit (No longer applicable)

Note: You must provide proof to support your exemption. See the instructions (opens in a new window) for more information.

Not applicable

A I am an employee of a federal or provincial public administration posted outside Canada.

B I am an employee, posted outside Canada, of an international organization of which Canada is a member and to which Canada contributes.

C I am a person who lives with an elector mentioned in A or B, or with a member of the Canadian Forces posted outside Canada, or with a civilian employed outside Canada as a teacher or as administrative support staff in a Canadian Forces school.

Name of Employer

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Registration Status

If your personal information is not already in the National Register of Electors, do you want it to be added?

Yes
No

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Attach Images of Your Supporting Documents

Only pieces of ID authorized by the Chief Electoral Officer will be accepted. If applicable, also attach proof of employment. See the instructions (opens in new window) for more information.

Select the image file(s) you want to upload:

Choose file 1  

Choose file 2  

Choose file 3  

Choose file 4  

Choose file 5  

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Declaration

I certify that the following statements are true and correct.

1. I am a Canadian citizen. I am 18 years old or older, or will be 18 years old or older on election day.
2. All statements made in this application are true and correct.

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Please leave this field blank