Household Voter Registration Form

Don't Lose Your Right to Vote

Address of Property: *

Postcode: *

Before completing this form you should read through the Canvass Guidance to Voters that accompanies it.

Click here to read the Canvass Guidance to Voters Help Icon

Click here to read Canvass Guidance to Voters

Please tick the box to indicate that you have read the Canvass Guidance to Voters *

Please tick the box to indicate that you have read the Canvass Guidance to Voters

You are required by law to give the information asked for in this form. You are entitled to register to vote if you are a British, Irish, European or qualifying Commonwealth citizen.

What are the details of the people resident at this address?

List below everyone living at your address on 15 October 2012 who is entitled to vote. Click on "Add" at the end of the line to create space for details relating to additional residents.

Young people can vote as soon as they are 18 and they should be registered now. Please list any 16 and 17 year olds. DO NOT INCLUDE CHILDREN UNDER 16

Surname	First Name & Middle Initial	NationalityPlease enter nationality. Due nationals should enter both nationalities.	Postal VotingWould you like a postal vote?	16 or 17 year oldsDates of births for 16 or 17 year olds	Jury Service (Is the person over 70 years old)	Opt OutDo you want to opt out of the edited register
Surname	First Name & Middle Initial	Nationality	Postal Voting	16 or 17 year olds Month Day Year	Jury Service (Is the person over 70 years old)	Opt Out

New Occupiers

Have you moved within the last 12 months?

Yes

Previous Address:

Date you moved:

If no-one is entitled to vote

If no-one at this address is entitled to register to vote (including you), please tick the appropriate box and sign the form before returning:

Property is/will be empty on 15th October

Property is empty now, but may be occupied on 15 October

All residents not entitled to vote due to their nationality

Other reason

Please give details:

Please state why:

About You

Name:

Date:

Tel. No. (optional):

Email Address: *

Please click "Submit" and this will generate a form for you to sign and return to electoralservices@bedford.gov.uk or if you prefer:

Electoral Services
Registration and Records Unit
Borough Hall
Cauldwell Street
Bedford
MK42 9AP

eForms by AchieveForms

Bedford Borough Council
Borough Hall
Cauldwell Street
Bedford
MK42 9AP

Tel. 01234 267422