January 27, 2015 First Supervisorial District Vacancy Election Vote-by-Mail Application


 

Please Note the Following:

  1. The deadline to submit this application is January 20, 2015.
  2. You must currently be a registered voter in the First Supervisorial District to use this application. You may verify if you are registered by clicking here.
  3. Your Orange County residential address must be provided.
  4. This form can not be used to change your name or address.
  5. This is a one-time only application. If you would like to become a permanent vote-by-mail voter, please click here.
  6. If you are a college student with a temporary residence, please use your permanent address as your residential address, and your temporary address as your mailing address. If you are not registered in Orange County, please contact your local elections official.

If you are currently a permanent vote-by-mail voter, as indicated on your sample ballot, you do not need to fill out this application.

Full name:
Residential Address:
 
City:
State:
Zip:
My mailing address is the same as my residential address

Mailing Address (if different than residential address; please include full address including city):

 
Date of birth: