MAINE VOTER REGISTRATION APPLICATION
This portion must be completed.
Federally required questions:
Are you a citizen of the United States of America?
Will you be 18 years of age on or before Election Day? YES NO
I do not wish to enroll in a
(If you checked “no” in response to either of these questions, do not
political party at this time
complete this form.)
(designated as “Unenrolled”)
DATE OF BIRTH
_ _/ _ _ / _ _ _ _
Y Y Y Y
STREET OR LOCATION ADDRESS (Where you live)
(STREET NAME AND NUMBER, NOT A P.O. BOX)
CITY, TOWN, PLANTATION OR TOWNSHIP
CURRENT MAILING ADDRESS (If different from address above)
NUMBER AND STREET OR P.O. BOX, etc.
PREVIOUS REGISTRATION ADDRESS (Complete or write “none” below)
COMPLETE BOTH SIDES OF THIS CARD – PLEASE PRINT