FORM 17 [See rule 28] 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
