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* This Field is required Information for: First name/ Prénom : <span> <div style="line-height: 135%"> Type your full first name followed by your middle name (if any)/ Tapez votre premier pr&eacute;nom suivi de votre second pr&eacute;nom (le cas &eacute;ch&eacute;ant). </div> </span>
* This Field is required Information for: Last name/ Nom : <div> Please enter your real name&nbsp;/ <span style="font-size: 10pt; color: #333399; font-family: Arial"><span style="color: #000000">Pri&egrave;re de taper votre nom de famille r&eacute;el</span>.</span> </div>
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Information for: Survivor of Former Nortel Employee/Ancien employé Nortel : <p>Leave this field blank unless you are a survivor of a former employee</p><p>&nbsp;</p><p>&nbsp;</p>
* This Field is required Information for: Status : <p style="margin: 0cm 0cm 0pt"> <span style="font-size: 10pt; font-family: Arial">Please</span><span style="font-size: 10pt; font-family: Arial"> select all&nbsp;applicable. / Pri&egrave;re de choisir tout ce qui est applicable.</span> </p>
* This Field is required Information for: Email/ Courriel : Please enter a valid e-mail address. A confirmation email will be sent to this address upon registration.
* This Field is required Information for: Username : Please create your username for future access to this web site. 3 character minimum with no spaces. May contain: 0-9, a-z, A-Z
* This Field is required Information for: Password/ Mot de passe : Please create your password for future access to this web site. 6 character minimum with no spaces. May contain: 0-9, a-z, A-Z<br />
* This Field is required Information for: Verify Password/ Mot de passe : Please create your password for future access to this web site. 6 character minimum with no spaces. May contain: 0-9, a-z, A-Z<br />
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* This Field is required Information for: Country - State/Province : <div> <span>Please select your country and State/Province, if not found, please select Other, and type the info in the next field.</span> </div> <div> <span>Pri&egrave;re de s&eacute;lectionner le Pays et l'&eacute;tat/ la Province, Si n'est pas dans la liste, pri&egrave;re de choisir &quot;Other&quot; et entrez l'information dans le champ suivant. </span> </div> <p> &nbsp; </p>
Information for: If other Contry - State/Province : Please leave blank if you selected the previous field<br /> Pri&egrave;re de laisser vide si le champ pr&eacute;c&eacute;dant est s&eacute;lectionn&eacute; <br /> <p> &nbsp; </p>
Information for: Additional Region of Interest/Autre région d'intérêt : <span><p>If you would like to get additional&nbsp; communications from a regional NRPC group other than your home area,&nbsp;please indicate which other region is of interest.</p><p>Si vous d&eacute;sirez obtenir de l'information d'une autre r&eacute;gion du groupe NRPC/SRNC&nbsp;autre que celle&nbsp;o&ugrave; vous demeurez, veuillez indiquer la r&eacute;gion qui vous int&eacute;resse.</p></span>
Information for: Federal Riding : <p>Please visit / Veuillez consulter</p><p><span style="line-height: 16px; border-collapse: collapse; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px; font-family: Arial, Helvetica, sans-serif; color: #333333"><a href="http://www.elections.ca/scripts/pss/FindED.aspx?L=e">http://www.elections.ca/scripts/pss/FindED.aspx?L=e</a></span></p>
Information for: Provincial Riding : <p>Please visit your provincial election web site to find out your riding, for example, for residents in Ontario, please visit</p><p><a href="http://fyed.elections.on.ca/fyed/en/form_page_en.jsp" target="_blank">http://fyed.elections.on.ca/fyed/en/form_page_en.jsp</a></p><span style="font-family: monospace, Helvetica, sans-serif"><span style="font-size: 12pt; font-family: Arial, Helvetica, sans-serif">Veuillez consulter le site web de votre directeur g&eacute;n&eacute;ral des &eacute;lections.<br /></span><span style="font-size: 12pt; font-family: Arial, Helvetica, sans-serif">Ex: Pour les r&eacute;sidents du Qu&eacute;bec, consultez</span><br /></span><p><a href="http://www.electionsquebec.qc.ca/francais/provincial/carte-electorale/trouvez-votre-circonscription.php">http://www.electionsquebec.qc.ca/francais/provincial/carte-electorale/trouvez-votre-circonscription.php</a>&nbsp;</p>
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