Curbside Voter Wait list

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Please select the Early voting location you are at *

Is there more than one qualified curbside voter in your vehicle? *

Yes

Please enter the number of participating curbside voters

Full name of voter *

Birth date of voter *

YYYY

Residential address of voter *

If there is more than one voter in the vehicle please provide additional voters full name, birth date, and address here.

A Phone number to contact with questions *

What number curbside stall are you parked in? *

Make, Model, and color of your vehicle *

Submit

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