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A. Information
If you are not sure if you are registered, call your county board of elections office.
Qualifications:
• You may only register to vote in the county where you reside.
• You must be a US citizen by birth or naturalization.
• You must be 18 years of age by the next general election.
• If you have been convicted of a felony, your rights of citizenship must be restored.
Requirements:
• Complete the sections below by printing legibly.
• Information required to process this application includes: name, residence address, date of birth, and signature.
• You may mail or hand-deliver this form to the board of elections in the county where you live.
If you choose to use this form to register to vote, the location where you have received this form will remain confidential and will be used
only for voter registration purposes. If you declined to be registered to vote, the fact that you so declined will remain confidential and will
be used only for voter registration purposes.
Please detach before mailing
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In order to vote in an election, this form must be postmarked or delivered no later than the 25th day before that election.
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C. Application to Register to Vote (Print Information and Sign Below) New Registration Change of Information
1) Are you a citizen of the United States of America? yes no 2) Will you be 18 years of age on or before election day? yes no
If you checked “no” in response to either of these questions, do not complete this form.
Last Name: First Name: Middle Name: Maiden Name: Suffix (Sr., II):
Address where you now live (Number and Street/Road/Dorm): Apt/Lot: City: County: State: NC
Zip:
Address where you get your mail (if different from above, also include zip code): Previous Name:
Previous Address (if you moved within the same county): Date of Birth: City and State of Birth: