Voter Registration Form

Online voter registration form for the state of Indiana.
* Required fields. Change State

Requirements

Are you a citizen of the United States of America? *

Yes

Will you be 18 years old on or before election day? *

Yes

Full Name

Salutation: *

First Name: *

Middle Name:

Last Name: *

Suffix:

Home Address

Street Address: *

Apt/Lot:

City/Town: *

State:

Zip Code: *

Mailing Address (If different than Home Address)

Street Address:

Apt/Lot:

City/Town:

State:

Zip Code:

Personal Information

Telephone:

Type of ID: *

ID Number:

Date of Birth: *

Month, Day, Year

Choice of Party:

Change of Name (Optional)

Salutation:

First Name:

Middle Name:

Last Name:

Salutation:

Previously Registered At

Street Address:

Apt/Lot:

City/Town:

State:

Zip Code:

State Instructions

To register in Indiana you must:
• be a citizen of the United States
• have resided in the precinct at least 30 days before the next election
• be at least 18 years of age on the day of the next general election
• not currently be in jail for a criminal conviction

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E-Mail *:

RECEIPT - Please send me a copy of this voter registration form for my files.

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