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Be a voter. Your voice matters.
Complete this form to pre-fill a voter registration application. It takes less than 2 minutes.
Name
*
First Name
Middle Name
Last Name
Suffix
Address Where You Live
*
Street Address
Apt or Lot #
City
Arkansas Residents Only
Zip Code
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*
Please Select
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Do you receive mail at a different address?
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Address Where You Receive Mail
Street Address
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State
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Please Select
ARKANSAS
ASHLEY
BAXTER
BENTON
BOONE
BRADLEY
CALHOUN
CARROLL
CHICOT
CLARK
CLAY
CLEBURNE
CLEVELAND
COLUMBIA
CONWAY
CRAIGHEAD
CRAWFORD
CRITTENDEN
CROSS
DALLAS
DESHA
DREW
FAULKNER
FRANKLIN
FULTON
GARLAND
GRANT
GREENE
HEMPSTEAD
HOT SPRING
HOWARD
INDEPENDENCE
IZARD
JACKSON
JEFFERSON
JOHNSON
LAFAYETTE
LAWRENCE
LEE
LINCOLN
LITTLE RIVER
LOGAN
LONOKE
MADISON
MARION
MILLER
MISSISSIPPI
MONROE
MONTGOMERY
NEVADA
NEWTON
OUACHITA
PERRY
PHILLIPS
PIKE
POINSETT
POLK
POPE
PRAIRIE
PULASKI
RANDOLPH
SALINE
SCOTT
SEARCY
SEBASTIAN
SEVIER
SHARP
ST FRANCIS
STONE
UNION
VAN BUREN
WASHINGTON
WHITE
WOODRUFF
YELL
Date of Birth
*
/
Month
/
Day
Year
Date Picker Icon
Party Affiliation (optional)
ID Number - Check the applicable box and provide the appropriate number.
*
Arkansas Driver’s license number
If you do not have a driver’s license, provide the last 4 digits of social security number
I have neither a driver’s license nor social security number.
Arkansas Driver's License Number
*
Last 4 Digits of Social Security Number
*
Have you ever voted in a federal election in this State?
*
Yes
No
A) Are you a citizen of the United States of America and an Arkansas resident?
*
Yes
No
B) Will you be eighteen (18) years of age or older on or before election day?
*
Yes
No
C) Are you presently adjudicated mentally incompetent by a court of competent jurisdiction?
*
Yes
No
D) Have you ever been convicted of a felony without your sentence having been discharged or pardoned?
*
Yes
No
You have entered a response that indicates you may not be eligible to vote in Arkansas. Please verify your answer is correct.
For assistance, email info@getloudarkansas.org or call 501.232.3011
Check all that apply
*
This is a new registration
This is a name change
This is an address change
This is a party change
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Next
Please complete the sections below if:
• You were previously registered in another county or state, or• You wish to change the name or address on your current registration.
Previous Name (if applicable)
First Name
Middle Name
Previous Last Name
Previous Address (if applicable)
Previous House Number and Street Name
Apt. or Lot#
City
State
Zip Code
Previous County
Please Select
ARKANSAS
ASHLEY
BAXTER
BENTON
BOONE
BRADLEY
CALHOUN
CARROLL
CHICOT
CLARK
CLAY
CLEBURNE
CLEVELAND
COLUMBIA
CONWAY
CRAIGHEAD
CRAWFORD
CRITTENDEN
CROSS
DALLAS
DESHA
DREW
FAULKNER
FRANKLIN
FULTON
GARLAND
GRANT
GREENE
HEMPSTEAD
HOT SPRING
HOWARD
INDEPENDENCE
IZARD
JACKSON
JEFFERSON
JOHNSON
LAFAYETTE
LAWRENCE
LEE
LINCOLN
LITTLE RIVER
LOGAN
LONOKE
MADISON
MARION
MILLER
MISSISSIPPI
MONROE
MONTGOMERY
NEVADA
NEWTON
OUACHITA
PERRY
PHILLIPS
PIKE
POINSETT
POLK
POPE
PRAIRIE
PULASKI
RANDOLPH
SALINE
SCOTT
SEARCY
SEBASTIAN
SEVIER
SHARP
ST FRANCIS
STONE
UNION
VAN BUREN
WASHINGTON
WHITE
WOODRUFF
YELL
Back
Next
COMPLETE FORM
Remember, you are not registered to vote until the voter registration application has been accepted by your county clerk. Upon acceptance, you will receive a card in the mail confirming your voter registration status.
Email Address
*
This information will be used to email your prefilled PDF. For your privacy, it will not be included on the voter registration application.
Phone Number (optional)
Providing a phone number will help us follow up if there are any issues with your registration. For your privacy, it will not be included on the voter registration application.
Today's Date
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Month
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Day
Year
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Full Name
First Name
Last Name
Office
Phone
Short Text
Long Text
Email
example@example.com
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