Join Lily's Nomination Campaign Team today!

You have a role to play – are you interested in joining Lily's Nomination Campaign Team?

Please fill-out following form and a campaign team member will get back to you.
All space need be filled. If you do not hear from us for 3 business days, please email us.

Your Title
First Name
Last Name
Mailing Adress
City
Postal Code
Province
Day Phone
Evening Phone
Mobile Phone
DOB
(mm/dd/yyyy)

Are you a Liberal Party (LP) member?
   
What is your occupation?