Are You a Canadian Citizen?

YesNo

Are You a Resident of Steinbach?

YesNo

Have you owned your property or resided in the City of Steinbach since April 28, 2026?

YesNo

Will you be 18 years of age on or before October 28, 2026?

YesNo

First Name

Last Name

Civic Address

Owner or Tenant?

OwnerTenant

Mailing Address

Postal Code

Phone Number

Email Address

Acknowledgement of Accuracy

I hereby certify that the above information given are true and correct to the best of my knowledge.

Submit