Application Request

Voter Registration Applications must be POSTMARKED by the registration deadline.

Complete the form below to request a voter registration application to be mailed to you. Please allow time for your application to be mailed. Once you receive the application, you will need to complete it and submit to your local election authority in order to be registered to vote. If you have questions, please call the Elections Division at 1 (800) Now Vote (669-8683).

* Denotes required fields


* First Name:
* Last Name:
* Street Address:
* City:
* State:
* Zip Code:
Birthday:*	- - (MM-DD-YYYY)
Telephone Number:	() -
Email: