Regional elections

Candidacy application form

Candidacy for the regional elections — fields marked * are required.

Electoral information

Region

Province / Prefecture(optional)

Commune / Branch(optional)

Circumscription number (الدائرة الإنتخابية)(optional)

Voter-list registration number(optional)

Official candidacy photo (high quality)(optional)

Drag and drop a photo here, or click to browseJPG, PNG or WEBP — 15 MB max

Full name

National ID (CIN)

Date of birth

Place of birth

Profession

Education level

Family status

Last diploma obtained(optional)

Mobile phone

Landline phone(optional)

Email address

Postal address

Party join date(optional)

Number of congress participations(optional)

Responsibility — local section(optional)

Responsibility — provincial section(optional)

Responsibility — regional section(optional)

National responsibilities(optional)

Communal council(optional)

District (arrondissement) council(optional)

Provincial council(optional)

Regional council(optional)

House of Representatives(optional)

House of Councillors(optional)

Professional chamber(optional)

Socio-professional sector — Concerned?

Parallel organization — Concerned?

Associative activity — Concerned?

Union activity — Concerned?