General Information

Important: You must enter the requested information for all required (*) fields below.

Check this box if you: previously requested a Vote by Mail ballot and have not received it, or made a mistake, damaged or lost your ballot and want to request a new one.

Name (For single name, please use Last Name field)

First Name

Middle Name

*Last Name

Date of Birth

*Date of Birth (Ex: mm/dd/yyyy)

Phone Number

Daytime (Optional)

Evening (Optional)

Request a Crossover Ballot

If you’re registered to vote with No Party Preference you may crossover into the American Independent Party, Democratic Party and Libertarian Party and request their Presidential Primary ballot.

Check this box to request a crossover ballot.

Please select a party

Notice: If you’re registered with No Party Preference and want to receive a Vote by Mail ballot for the Green, Peace & Freedom or Republican party, you must change your party affiliation by completing a new voter registration, click here.