Mail-In Voter Registration Application
apply to register to vote in West Virginia
change your address or name on your voter record
change your political party on your voter record
You Can Use This Form To:
West Virginia
Follow These Steps To Complete Form:
QUESTIONS?
Give your legal name--(last name, first name,
middle or maiden name--no nicknames)
Give your birth date--(month/day/year).
Enter your driver's license number. If you do
not have a driver's license number, enter the
last four numbers of your social security
number. If you do not have a driver's license
number or a social security number, an
identification number will be assigned to you.
If this form is submitted by mail & it is the first
time you have registered to vote in this
county, you MUST submit a copy of a current
and valid ID with this application or at the polls
the first time you vote. To send it with this
application you should enclose one of the
following:
(1) A copy of a current & valid photo ID with
current residence address or
(2) A copy of a current utility bill, bank
statement, government check, paycheck, or
other government document that shows your
name and current residence address.
Registration Deadline:
You may register at any time. In order to
vote in an election, you must be registered
twenty-one (21) days before that election.
Mailing Directions:
Provide all required information (1, 2, 3, 4
& 10) before mailing form to county clerk.
(required)
(required)
(required)
Note: If available, use black ink & print.
West Virginia Secretary of State
CALL TOLL FREE 1-866-SOS-VOTE
Box 9.
Box 1.
Box 2.
Box 3.
(required)
Provide residence & mailing addresses. If
the address where you live does not
include a street name & number, describe
where you live by giving a road number,
intersection, or landmark to help identify
your precinct. For military, overseas, or
students, list your military / school
address as your mailing address & your
legal West Virginia address for the
residence address. Provide a mailing
address if it is different than where you
live.
Mark if you live within city limits.
Give the telephone number where you can
be reached during the day.
Circle "M" for male or "F" for female.
Mark the party of your choice, list another
party on the line provided, or
mark the "No Party Choice" box. (Please
note: mark "No Party Choice" if you wish
to be an "independent" or no party.) You
may vote a party primary
ballot only if you are registered with that
party. However, some parties may allow
voters who are not registered with their
party to vote their party's ballot upon
request.
Check if this is a new registration, a name/
address change, or a party change.
Box 4.
Box 5.
Box 6.
Box 7.
Box 8.
Box 11.
(required)
Check applicable boxes & sign your
name if you meet these requirements.
Signature must match the name given
in Box 1. Note: It is a felony to sign
this form if you know you do not meet
the requirements listed in Box 10.
If you were registered before, enter
your full name & complete address as
they were on your last registration.
Box 10.
Motor Voter registrants please note: If you decline
to register to vote, your decision will remain
confidential. When you register to vote, your
information will remain confidential and may be
used only for voter registration purposes.
Go to www.WVvotes.com or
