SmartTrip Registration

Required fields are marked with an asterisk (*)

In accordance with Section 485 of the Municipal Government Act (MGA), any personal information collected on this registration form will only be used by municipal staff and, if necessary, individuals and/or organizations under service contract with the Halifax Regional Municipality for purposes relating to processing the SmartTrip registration form.

If you have any questions about the collection and use of your personal information, please call 311 or email contactus@311.halifax.ca.

Organization Information:

Organization Name: *

Address

Address 2

City/Town

ZIP/Postal Code

Workplace Size:

Number of Employees: *

Primary Contact Information:

Full Name: *

Job Title: *

Email Address: *

Phone Number: *

How Did You Hear About Our Program?