HomeMy WebLinkAboutForm CN02 - Candidate Information Release Form - FillableCandidate Information
Release Form
I, ____________________________________, ☐ authorize ☐ do not authorize (check one)
(Please Print)
the County of Newell to release for publication purposes the below listed candidate information while
participating in the 2021 General Municipal Election. I acknowledge that the County of Newell may
use my candidate information on their County website or provide my information to the media and
members of the public.
Candidate Information:
NAME ______________________________________________
MAILING ADDRESS
& POSTAL CODE: ______________________________________________
HOME PHONE NUMBER: ______________________________________________
OFFICE PHONE NUMBER: ______________________________________________
OTHER PHONE NUMBER: ______________________________________________
FAX NUMBER: ______________________________________________
EMAIL ADDRESS: ______________________________________________
__________________________________ ____________________
Signature Date
Collection and Use of Personal Information
Personal information is being collected under the authority of section 33(a) and (c) of the Freedom of Information and
Protection of Privacy Act, and will be used and disclosed as required for the management and administration of the election
process under the Local Authorities Election Act. If you have questions regarding the collection, use or disclosure of this
information, please contact the Executive Assistant at 403-794-2319.
Form CN02