STATE OF OHIO
 WARREN COUNTY BOARD OF ELECTIONS
VOTER REGISTRATION APPLICATION FORM

In order for this form to be valid:

* You must be a U.S. citizen

* You must be at least 18 years of age on or before the next general election

If you do not meet the above criteria please press the cancel button to be directed back to the previous page or press the OK button to continue.

Test    
Last Name: * Last Name Required
First Name: * First Name Required
Middle Name or Initial:
Jr., II, ect.:
House Number and Street: * Address Required
Apt. or Lot #:
City or Post Office: * City Required
Zip Code: * Zip Code Required
Additional Rural or Mailing Address (if necessary):

County where you live: Your Birthday:

YOU MUST CHOOSE ONE OF THE TWO ITEMS LISTED 

	Drivers License No:	Where is my Drivers License Number?
	Last 4 Digits of SSN:

 

Phone No. (Voluntary)

ADDRESS CHANGE ONLY - PREVIOUS ADDRESS
Address:
City:
State:
County:

NAME CHANGE ONLY
Former Legal name:

• * Last Name Required
• * First Name Required
• * Address Required
• * City Required
• * Zip Code Required