REGISTRATION LOCATION
ON LAND OR ONLINE
ELIGIBLE CITIZEN
Name
Address
City / State / Zip
Date of Birth
Signature
Date
✦ ✦ ✦
REGISTERED
VOTER
✦
Certified to Join
THE VOICE OF THE PEOPLE
✦
✦
YOUR STATE
OFFICIAL SEAL
1776
✦
2026
Commemorating 250 Years
✦ ✦ ✦
REGISTERED
VOTER
✦
✦
Celebrate
National Voter Registration Day
Help find eligible citizens and share.