PIAC Ward 5 Election Voter Registration Form

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Electors shall be Toronto District School Board parents or guardians, as defined by Ontario Regulations 612/00 and 330/10.

This voter registration form is for the PIAC Ward Election in WARD 5 for the Co-Representative position(s).

The deadline to submit the Voter Registration Form is: December 12, 2022 at Noon

A ballot will be sent to verified voters.

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REFERENCES:

List of TDSB Wards - https://www.tdsb.on.ca/Find-your/School/PDF-Map

Email *

First Name *

(Enter your Legal First Name, as provided to your child's school.)

Last Name *

(Enter your Legal Last Name, as provided to your child's school.)

Street Address *

Postal Code *

Phone Number

Declaration of Eligibility

As defined by the Ontario Regulations 612/00 and 330/10, the voter shall be a Toronto District School Board parent or legal guardian AND meet at least one of the following criteria: (1) Voter's child(ren) attends school in the ward; (2) Voter's child(ren) lives in the ward; OR (3) Voter resides in the ward.

I declare that I am a TDSB parent or legal guardian AND meet at least one of the following criteria: *

(Select all that apply.)

I am a parent/guardian of a child enrolled in a TDSB school in this ward.

My child resides in the ward.

I reside in this ward.

Required

Child's Name *

(Enter your child’s legal full name as provided to the school.)

Child's Street Address *

Child's Postal Code *

Child's School (listed below are schools in Ward 5 only) *

Please provide school name If you child goes to a school outside Ward 5.

Signature

Confirmation of Information *

I confirm that the information as provided in this Nomination Form is accurate and complete.

Notice Regarding Collections, Use and Disclosure of Personal Information by the Toronto District School Board *

Personal information on this form is collected under the authority of Ontario Regulation 612/00 (School Councils and Parent Involvement Committees) under Education Act, R.S.O. 1990, c. E.2, as amended and will be used by Toronto District School Board (“TDSB”) to determine eligibility, plan the election process, gather nominations and run the election. The information is retained in accordance with Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. M56 and will be disclosed to authorized TDSB staff and TDSB’s Parent Involvement Advisory Committee (“PIAC”) in order to administer the above purposes. Questions regarding this collection should be directed to Parent and Community Engagement Coordinator, TDSB Parent and Community Engagement Office at PIAC.Chair@tdsb.on.ca, or at 5050 Yonge Street, Toronto, Ontario, M2N 5N8, or at 416-395-4808.

I have read and agree to the Notice of Collections, Use and Disclosure of Personal Information.

A copy of your responses will be emailed to the address you provided.

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