Voter Registration and Permanent Early Voting List Signup
This form is intended to make voting as easy and seamless as possible.
The Early Voter Registration deadline is Monday July 28.
Please ensure all fields are filled out accurately.
You will receive your ballot by mail.

Thank you!
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First Name *
Last Name *
Date of Birth *
Address *
123 Mesa Ln.
City *
State *
Zip Code *
Drivers License Number *
D99999999 (top right corner of drivers license)
Email Address *
Please ensure this is correct
Phone Number *
I would like to register to vote *
I would like to sign up for the Permanant Early Voting List (PEVL) *
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