Election Registration Form             

 

wpe1C.jpg (2883 bytes)Voter Registration

Name____________________________

Date_____________________________

Birth date _________________________

Address ____________________________________________

             ____________________________________________

Where were you born? ________________________________________

How long have you lived at your current address? ____________________

wpe1C.jpg (2883 bytes)Voter Registration

Name____________________________

Date_____________________________

Birth date _________________________

Address ______________________________________________

             _______________________________________________

Where were you born? ________________________________________

How long have you lived at your current address? ____________________