Green Party of NY 2016 Presidential Absentee Ballot Request Form
This form is for enrolled members of the Green Party of NY to request a mail-in, absentee ballot for presidential preference to be counted at our June 11 State Nominating Convention in Troy, NY.

Only votes from those who have registered to vote with the NY State Board of Elections as a member of the Green Party in time to appear on the April 2016 enrollment list will be counted, with the exception New York state residents legally barred from registering to vote who have joined GPNY through the Supporting Members program.

**Please enter all information as it appears on your voter registration** You can check your voter registration information at:

(UPDATED) Ballot must be postmarked by June 6th, 2016 and sent to the address listed on the ballot.

First Name
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Last Name
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Date of Birth (MM/DD/YYYY)
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Zip Code
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Email Address
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Please Choose One:
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