Test Registration Page

Registrant Name*

Are you a consultant lobbyist or an in-house lobbyist?*

Consultant
In-House

Consulting Lobbyist Information

First Name of Consultant Lobbyist*

Surname of Consultant Lobbyist*

Add the Lobbyist Business Contact information

Address	Actions
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Email of Consultant Lobbyist Business*

Phone Number of Consultant Lobbyist Business*

Consulting Lobbyist Firm Information

Please enter information about the firm, if any, which employs to you lobby on behalf of your client.

Are you employed by a firm to lobby on behalf of your client?*

Yes
No

What is the name of the firm that employs you to lobby on behalf of your client?

Phone Number of firm that employs you to lobby on behalf of your client:

Email address of the firm that employs you to lobby on behalf of your client

In House Organization

Enter the organization name and details of the organization.

Name	Address	Actions
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Briefly describe the organization's business activities

Lobbyists

Name	Address	Actions
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Anticipated end date of lobby activities:*

In-house Lobbyist’s Information

Lobbyists

Provide the name, position title of each in-hoiuse lobbyist for the organization

Name	Address	Actions
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Anticipated end date of lobbying activities:

Client Contact Information

Please enter business name and address of the client on who's behalf you are lobbying

Business Name	Address	Actions
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Please enter the phone number of the client on who's behalf you are lobbying

Government Funding Information

Is the client funded in whole or in part by the government or government institution?

Yes
No

During the past fiscal year, did any government or government institution fund or partly fund the organization??*

Yes
No

Amount:*

Type of Government Institution:*

Government Institution Name*

Private Funding Information

Did your client receive private funding for the purpose of supporting this lobbying activity?*

Yes
No

Amount:*

Please enter the name of the source of this private funding*

Control or Direct Organization's Activities Information

Does any individual or organization have control over or direct the organization’s activities and have a direct interest in the outcome of the lobbying activities?

Yes
No

List every individual or organization, along with their address, that has control over or directs this organization.

Individual or Organization Name	Address	Actions
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Client’s Controlling or Directing Interests Information

Does any individual or organization have control over or direct the client’s activities and have a direct interest in the outcome of the lobbying activities?

Yes
No

Identify each person or organization, along with their address, that to your knowledge has control over or directs the clients activities and who have a direct interest in the outcome of these lobbying activities on the client's behalf.

Individual or Organization Name	Address	Actions
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Contribution to Lobbying Activities

In the client's last fiscal year did any invididual or organization contribute funding towards the lobbying activities on behalf of the client?

Yes
No

List the names and addresses of these individuals and/or organizations:

Name	Address	Actions
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In your organizations' last fiscal year did any organization contribute funding towards the lobbying activities on behalf of your organization?

Yes
No

List the names and addresses of all such organizations:

Name	Address	Actions
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Senior Officer Contact Information

Name of the Senior Officer

First Name Surname

Address of Senior Officer

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email of Senior Officer

Organization Information

Enter the Name and Address of the Organization

Name	Address	Actions
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Phone of the Organization

Email of the Organization

Provide a general description of the membership or your organization*

This includes: Whether or not your organization is a partnership, or a sole proprietorship: if it is a business, trade, industry, professional or voluntary organization, a union or labour organization, a chamber of commerce or a board of trade, an association, a charitable or non-profit organization, a society, a coalition, or interest group, or if it is a government other than the Government of New Brunswick

First name and Surname of the other officers of the organization

First Last

Is your organization a corporation?

Yes
No

Please provide the First and Surnames of each of the directors of the corporation

First Last

Subsidiary Business Contact Information

Enter the name and business address of each corporation controled by your organization that, to your knowledge, has a direct interest in the outcome of your lobbying activities.

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Controlling Corporation Business Information

Enter the name and business address of each corporation that controls your corporation

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Government Funding Information

Does your client receiving funding from any Government or Government Agency?

Yes
No

List the name of any Government or Government Agency that funds or partially funds your client

Lobbyist Information

Coalition Information

Is the client a member of a coalition?

Yes
No

List all the individuals, organizations and/or companies who have formed a coalition for these lobbying activities:

Name	Address	Actions
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Is the organization a member of a coalition?

Yes
No

List all the individuals, organizations and/or companies who have formed a coalition for this project:

Name	Address	Actions
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Government Institutions

Choose all the government institutions the lobbyist has, or expects to lobby.

Ministers

Has, or does the lobbyist expect to, lobby any New Brunswick provincial government Ministers?

Yes
No

Has the organization lobbied or expects to lobby, any New Brunswick provincial government ministers?

Yes
No

Ministers (in their respective portfolios) the lobbyist has lobbied, or expects to lobby. Select all the ministers the lobbyist has or expects to lobby.

Members of the Legislative Assembly

Have any of the lobbyists already lobbied, or expect to lobby, any Member of the New Brunswick Legislative Assembly?

Yes
No

Has the organization lobbied, or does it expect to lobby any Members of the New Brunswick Legislative Assembly?

Yes
No

Select all the Members of the New Brunswick Legislative Assembly the lobbyist has lobbied, or expects to lobby.

Other Senior Public Office Holders

Has the organization lobbied, or does it expect to lobby, any other Senior Public Office Holder?

Yes
No

Please enter the information for all Senior Public Office Holders the lobbyists have, or expect to lobby.

Position Title	Government Institution:	Actions
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Communication Techniques

Select all the techniques of communication that were used/expect to be used in the course of lobbying activities.

Grassroots communications
Informal communication
Meetings
Phone Calls
Presentations
Written communication whether in hard copy or electronic format

Details of the Lobbying Activity

Describe the focus of the lobbying activities:*

Does the above represent an accurate and complete account of your lobbying activities?

Yes
No

If no, please provide further details:

Subject Matters

Subject Matters. Please select all that applies to your lobbying activities.

Certification

I certify that the information contained in this return is true and accurate to the best of my knowledge and belief.

Signature of Senior Officer (Please Type)*

Signature of Consultant Lobbyist (Please Type)*

Date*

Aboriginal Affairs
Agriculture, Aquaculture and Fisheries
Ambulance NB/EM/ANB Inc.
Anglophone North School District
Anglophone East School District
Anglophone South School District
Anglophone West School District
Cannabis NB Ltd.
District Education Council Anglophone North
District Education Council Anglophone East
District Education Council Anglophone South
District Education Council Anglophone West
District Education Council Francophone Nord-ouest
District Education Council Francophone Nord-est
District Education Council Francophone Sud
Economic and Social Inclusion Corporation
Economic Development and Small Business
Education and Early Childhood Development
Emergency Measures Organization
Energy and Resource Development
Environment and Local Government
Executive Council Office
Finance
Financial and Consumer Services Commission
Games of La Francophonie
Francophone nord-ouest school district
Francophone nord-est school district
Francophone sud school district
Health
Horizon Health Network
Housing
Intergovernmental Affairs
Justice and Office of the Attorney General
Kings Landing Corporation
Labour and Employment Board
Midwifery Council of New Brunswick
M.O.R.E. Services Inc.
New Brunswick Arts Board
New Brunswick Community College (NBCC)
New Brunswick Credit Union Deposit Insurance Corporation
New Brunswick Energy Marketing Corporation
New Brunswick Energy & Utilities Board
New Brunswick Health Council
New Brunswick Human Rights Commission
New Brunswick Insurance Board
New Brunswick Legal Aid Services Commission
New Brunswick Liquor Corporation
New Brunswick Museum
New Brunswick Police Commission
New Brunswick Power Corporation
New Brunswick Public Library Service
New Brunswick Research and Productivity Council
New Brunswick Women’s Council
Office of the Premier
Opportunities NB
Post-Secondary Education,Training and Labour
Premier’s Council on Disabilities
Public Safety
Regional Development Corporation
Service New Brunswick
Social Development
Team New Brunswick (Canada Games)
Tourism, Heritage and Culture
Transportation and Infrastructure
Treasury Board
Village historique acadien
Vitalité Health Network

Aboriginal Affairs
Agriculture, Aquaculture and Fisheries
Ambulance NB/EM/ANB Inc.
Anglophone North School District
Anglophone East School District
Anglophone South School District
Anglophone West School District
Cannabis NB Ltd.
District Education Council Anglophone North
District Education Council Anglophone East
District Education Council Anglophone South
District Education Council Anglophone West
District Education Council Francophone Nord-ouest
District Education Council Francophone Nord-est
District Education Council Francophone Sud
Economic and Social Inclusion Corporation
Economic Development and Small Business
Education and Early Childhood Development
Emergency Measures Organization
Energy and Resource Development
Environment and Local Government
Executive Council Office
Finance
Financial and Consumer Services Commission
Games of La Francophonie
Francophone nord-ouest school district
Francophone nord-est school district
Francophone sud school district
Health
Horizon Health Network
Housing
Intergovernmental Affairs
Justice and Office of the Attorney General
Kings Landing Corporation
Labour and Employment Board
Midwifery Council of New Brunswick
M.O.R.E. Services Inc.
New Brunswick Arts Board
New Brunswick Community College (NBCC)
New Brunswick Credit Union Deposit Insurance Corporation
New Brunswick Energy Marketing Corporation
New Brunswick Energy & Utilities Board
New Brunswick Health Council
New Brunswick Human Rights Commission
New Brunswick Insurance Board
New Brunswick Legal Aid Services Commission
New Brunswick Liquor Corporation
New Brunswick Museum
New Brunswick Police Commission
New Brunswick Power Corporation
New Brunswick Public Library Service
New Brunswick Research and Productivity Council
New Brunswick Women’s Council
Office of the Premier
Opportunities NB
Post-Secondary Education,Training and Labour
Premier’s Council on Disabilities
Public Safety
Regional Development Corporation
Service New Brunswick
Social Development
Team New Brunswick (Canada Games)
Tourism, Heritage and Culture
Transportation and Infrastructure
Treasury Board
Village historique acadien
Vitalité Health Network

Consulting Lobbyist Information

Consulting Lobbyist Firm Information

In House Organization

In-house Lobbyist’s Information

Client Contact Information

Government Funding Information

Private Funding Information

Control or Direct Organization's Activities Information

Client’s Controlling or Directing Interests Information

Contribution to Lobbying Activities

Senior Officer Contact Information

Organization Information

Subsidiary Business Contact Information

Controlling Corporation Business Information

Government Funding Information

Lobbyist Information

Coalition Information

Government Institutions

Ministers

Members of the Legislative Assembly

Other Senior Public Office Holders

Communication Techniques

Details of the Lobbying Activity

Subject Matters

Categories

Certification