REQUEST & MAIL

Voter Registration Applications must be POSTMARKED by the Election Day deadline.

Please allow time for your application to be mailed to you. After the Election Day deadline, please call the Elections Division at 1 (800) Now Vote (669-8683) to make sure your appliation will arrive in time.

This form can be used to request a voter registration application. If you complete the form below and submit it to the Secretary of State's office, a voter registration application will be mailed to you.

* Denotes required fields


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

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