Form -17 Application for inclusion of name in the electoral roll for a local authorities' constituency To The Electoral Registration Officer, .......................................(Local Authorities) Constituency. Sir, I am a member of ......................... which is a constituent local authority exercising jurisdiction within the limits of the ..............................................local authorities' constituency. I am therefore entitled to be registered as an elector in the said constituency, and request that my name be included in the electoral roll thereof. My address is: ............ ............ ........... Yours faithfully,
