Contact Information

The election office asks for your email to ensure they can contact you for any follow-up

State officials require your Social Security Number to verify your identity.

State officials require your Driver's License or State ID number to verify your identity.

1. Personal Information Edit Email Address {Email:26} Name Prefix: {Full Name (Prefix):39.2} First name: {Full Name (First):39.3} Middle name: {Full Name (Middle):39.4} Last name: {Full Name (Last):39.6} Suffix: {Full Name (Suffix):39.8} Previous names: {Previous names (leave empty if none):9} Birth date {Birth date (MM/DD/YYYY):12}
2. Address Edit The address in the US where you are registering to vote: {US Address (Street Address):18.1}
   {US Address (Address Line 2):18.2}
   {US Address (City):18.3}, {US Address (State / Province):18.4} {US Zip:18.5}
   {US Address (Country):18.6}
   
   {U.S. Voting County Long Name:98} Your current mailing address: {Your mailing address (Street Address):23.1}
   {Your mailing address (Address Line 2):23.2}
   {Your mailing address (City):23.3}, {Your mailing address (State / Province):23.4} {Your mailing address (ZIP / Postal Code):23.5}
   {Your mailing address (Country):23.6} Your mail forwarding address: {Your mail forwarding address (Street Address):24.1}
   {Your mail forwarding address (Address Line 2):24.2}
   {Your mail forwarding address (City):24.3}, {Your mail forwarding address (State / Province):24.4} {Your mail forwarding address (ZIP / Postal Code):24.5}
   {Your mail forwarding address (Country):24.6}
3. Additional Information Edit Voting Classification I have never lived in the United States. Political Party {What is your political party for primary elections?:32} How do you want to receive voting materials from your election office? {A. How do you want to receive voting materials from your election office?:31} Phone Number {Additional ways for your election office to contact you:27}
4. Identity Verification Edit Social Security Number {Last four digits of your Social Security Number:77} {Social Security Number:11} N/A Driver's License or state ID {Driver’s License or State ID Number:105}