Please complete this form IF you are a student at the Belleville campus who would like to vote but are unable to visit one of these on campus polling stations during the election:
-Monday, March 27 from 9 am - 4 pm (5 locations)
-Tuesday, March 28 from 9 am - 4 pm (5 locations)
-Tuesday, March 28 from 7-9 pm (Residence Commons PLEASE NOTE: You do not have to be living on campus to visit this polling station.)
-Wednesday, March 29 from 9 am - 4 pm (5 locations)
-Thursday, March 30 from 9 am - 4 pm (5 locations)
-Friday, March 31 from 9 am - 2 pm (5 locations)

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* 1. Name

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* 2. Student Number

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* 3. Email Address

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* 4. Phone Number

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* 5. Please indicate the reason you are unable to visit an on campus polling station.

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