51AV

Voter Registration Application Instructions:

Before filling out the body of the form, please answer the questions on the top of the form as to whether you are a United States citizen and whether you will be 18 years old on or before Election Day. If you answer no to either of these questions, you may not use this form to register to vote. However, state specific instructions may provide additional information on eligibility to register to vote prior to age 18.

• Box 1 鈥� Name
  • Place your full name in this order 鈥� Last, First, Middle.
  • Do not use nicknames or initials.
  • Note: If this application is for a change of name, please tell us in Box A (on the bottom half of the form) your full name before you changed it.
• Box 2 鈥� Home Address
  • Place your home address (legal address) in this box.
  • Do not put your mailing address here if it is different from your home address.
  • Do not use a post office box or rural route without a box number.
• Box 4 鈥� Date of Birth
  
  • Indicate your date of birth in this order 鈥� Month, Day, Year.
  • Be careful not to use today鈥檚 date!
• Box 5 鈥� Telephone Number
  • Most states ask for your telephone number in case there are questions about your application. However, you do not have to fill in this box.
• Box 6 鈥� ID Number
  
  • Federal law requires that states collect an identification number from each registrant.
  • You must refer to your state's specific instructions for item 6 regarding the information on what number is acceptable for your state.
  • If you have neither a driver鈥檚 license nor a social security number, please indicate this on the form, and a number will be assigned to you by your state.
• Box 7 鈥� Choice of Party
  
  • In some states, you must register with a party if you want to take part in that party鈥檚 primary election, caucus, or convention.
  • To find out if your State requires this, see item 7 in the instructions under your state.
  • If you want to register with a party, print in the box the full name of the party of your choice.
  • If you do not want to register with a party, write 鈥渘o party鈥� or leave the box blank.
  • Do not write in the word 鈥渋ndependent鈥� if you mean 鈥渘o party,鈥� because this might be confused with the name of a political party in your state.
  • Note: If you do not register with a party, you can still vote in general elections and nonpartisan (nonparty) primary elections.
• Box 8 鈥� Race or Ethnic Group
  
  • A few States ask for your race or ethnic group, in order to administer the Federal Voting Rights Act.
  • To find out if your State asks for this information, see item 8 in the instructions under your State.
  • If so, put in Box 8 the choice that best describes you from the list below:
    • American Indian or Alaskan Native
    • Asian or Pacific Islander
    • Black, not of Hispanic Origin
    • Hispanic
    • 惭耻濒迟颈鈥憆补肠颈补濒
    • White, not of Hispanic Origin
    • Other
• Box 9 鈥� Signature
  
  • Review the information in item 9 in the instructions under your state.
  • Before you sign or make your mark, make sure that: (1) You meet your State鈥檚 requirements, and (2) You understand all of Box 9.
  • Finally, sign your full name or make your mark, and print today鈥檚 date in this order 鈥� Month, Day, and Year.
  • If the applicant is unable to sign, put in Box D the name, address, and telephone number (optional) of the person who helped the applicant.

Sample 51AV Voter Registration Form