Register Online

Register Online

 

To Be Completed by Persons NOT REGISTERED

Please ensure the information entered is correct. After you fill out the form, please review it before you submit.


Male

Female


Address

I hereby apply to be registered in the parliamentary register of the following constituency:

I declare the applicant was born in (if applicable):






I declare that the applicant: (check all that apply)

Is a commonwealth citizen

Does not possess Bermudian status but was registered as an elector on 1 May 1976

Is not registered in the parliamentary register of any other constituency

Has not applied to be registered as an elector in any other constituency

Is not disqualified for registration as an elector

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