Voter Registration Form

Online voter registration form for the state of Pennsylvania.
* 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: *

Your state requires you to select a party to vote in all elections.

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 Pennsylvania you must:
• be a citizen of the United States at least one month before the next election
• be a resident of Pennsylvania and your election district at least 30 days before the election
• be at least 18 years of age on the day of the next election

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E-Mail *:

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

NEWSLETTER - Please send me the Register to Vote newsletter.

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