Registration Details

Registration Details Header Cell

1

Voter Eligibility
2

Voter Info
3

Citizenship
4

Additional Info
5

Address
6

Previous Info
7

Final Declarations
8

Review & Submit
9

Complete

Voter Eligibility

Fields marked with * are required fields

Voter Declaration Help Section Caption
Voter Declaration Help Section Heading

Voter Declaration Error Message Section Caption
Voter Declaration Error Message Section Heading

Voter eligibility fields section

Voter eligibility fields Section Caption

Check Yes or No below to identify your eligibility for vote
Voter Eligibility Confirmation
* Are you a citizen of the United States?	Citizen of United States Yes No
* Are you a resident of the State of Tennessee?	Resident of State of Tennessee Yes No
* Will you be 18 years of age or older on or before Election Day?	18 years of age before the Election Day Yes No
* Have you ever been convicted of a crime which is a felony in this state, by a court in this state, a court in another state, or a federal court?	Convicted of a crime Yes No
* I understand that voter registration records are public records, open to inspection by any citizen of Tennessee, excluding the social security number, driver’s license number, and the Department of Safety and Homeland Security ID number.	Department of Safety and Homeland Security ID. Yes No
* I understand that giving false information to register to vote or attempting to register when not qualified is a felony punishable by not less than two (2) years nor more than twelve (12) years imprisonment or a fine of $5,000 or both.	Attempting to register when not qualified Yes No

Voter Information

Fields marked with * are required fields

Personal Identifiable Information Help Section Caption
Personal Identifiable Information Help Section Heading

Personal Identifiable Information Error Section Caption
Personal Identifiable Information Error Section Heading

Voter Personal Info caption

Voter Personal Info heading

Personal Information of Voter

Voter Personal Info

VOTER REGISTRATION TYPE

Voter Registration Info

Voter Registration Info Grid Header

Select New Voter Registration if:

New Voter Registration Information Caption
New Voter Registration Information
●	You have never registered to vote in Tennessee
●	You were previously registered to vote in Tennessee but your county of residence has changed
●	You are not sure if you have previously registered to vote in your current Tennessee county of residence

Select Update Voter Registration if:

Update Voter Registration Information Caption
Update Voter Registration Information
●	You have moved within the county where you are currently registered to vote
●	You are currently registered to vote in your county but your name has legally changed

Check Registration type radio buttons
Check Registration type radio buttons section
Select Registration Type * New Voter Registration Update Voter Registration

PERSONAL INFORMATION

In order to register to vote or change your registration online, we must obtain your electronic signature from the Department of Safety and Homeland Security. The information you provide on this page will be submitted to the Department of Safety and Homeland Security in order to obtain a copy of your signature. Your county election office will keep a copy of this signature with your voter registration.

First Name: *

Middle / Maiden Name:

Last Name: *

Suffix:

Date of Birth: *

MM/DD/YYYY

Social Security Number: *

TN Driver’s License/ TN Department of Safety and Homeland Security ID (Optional):

Providing your DL number/Department of Safety and Homeland Security ID will allow the system to more easily find your digital signature

* I consent to the use of the information on this page for obtaining my digital signature from the Department of Safety and Homeland Security and I consent to using the obtained signature for my voter registration.

Personal Information confirmation Yes No

Citizenship Information

Fields marked with * are required fields

Safety Flaged As Non Citizen Help Section Caption
Safety Flaged As Non Citizen Help Section Heading

Safety Flaged As Non Citizen Validate Section Caption
Safety Flaged As Non Citizen Validate Section Heading

Safety Flaged As Non Citizen Main Content Section Caption

Safety Flaged As Non Citizen Main Content Section Heading

Citizenship Info section
Citizen Information
We are not able to verify you are a citizen of the United States with the Department of Safety and Homeland Security. If you are a United States citizen, please enter your date of citizenship and your naturalization number below. If you are not a U.S. citizen, do not complete this application.
If you have questions regarding the message, please contact the Division of Elections at 1-877-850-4959.
Date of U.S. Citizenship: *	MM/DD/YYYY
Naturalization Number: *

Additional Personal Information

Fields marked with * are required fields

Additional Personal Information Help Section Caption
Additional Personal Information Help Section Heading

Additional Personal Information Error Section Caption
Additional Personal Information Error Section Heading

Additional Personal Information Main Section Caption

Additional Personal Information Main Section Heading

Additional Personal Info heading

Additional Personal Information table heading

Place of Birth *

State of Birth caption
State of Birth heading
State of Birth (if born in the United States):
	OR
Country or Territory of Birth (if born outside the United States):

City of Birth: *

Gender: *

Gender Type Male Female

(Optional) Race:

(Optional) Phone Number:

Re-Enter Phone Number:

(Optional) Email:

Re-Enter Email:

Are you interested in working on Election Day?:

Are you interested in working on Election Day?: Yes No

If Yes, please provide a phone number or email address above.

Registration and Mailing Address

Fields marked with * are required fields

Residential Address Help Section Caption
Residential Address Help Section Heading

Residential Address Validate Section Caption
Residential Address Validate Section Heading

Residential Address Heading Caption
Residential Address Section Heading
RESIDENTIAL ADDRESS

Residential Address Information Main Section Caption

Residential Address Information Main Section Heading

Residential Address Info Caption

Residential Address Heading

County: *

Do not give a P.O. Box

Street Number: *

Street Name: *

Address Line 2:

Apartment Number:

City: *

State (Two Character Abbreviation): *

Zip Code (First 5 digits): *

(Optional) Zip Code (Last 4 digits):

Residential Address Affirmation Caption
Residential Address Affirmation Heading
	* I, being duly sworn on oath (or affirmation) declare that the above address is my legal residence and that I plan to remain at such residence for an undetermined period of time and say that to the best of my knowledge and belief, all the statements made by me are true.

MAILING ADDRESS Same as Residence

Confirmation of Overseas Mailing Address Section Caption
Confirmation of Overseas Mailing Address Section Heading
Is your mailing address overseas?	Is your mailing address overseas? Yes No
Is your mailing address a PO Box?	Is your mailing address a PO Box? Yes No

Street Number:

Street Number: *

Street Name/P.O. Box: *

Address Line 2:

Apartment Number:

City: *

State: *

Zip Code (First 5 digits): *

(Optional) Zip Code (Last 4 digits):

Street Name/Number/P.O. Box: *

Address Line 2:

City/Town, Municipal Sub Division Postal Code: *

Country: *

Name and Address On Your Last Voter Registration Record

Fields marked with * are required fields

Previous Name or Address Help Section Caption
Previous Name or Address Help Section Heading

Previous Name or Address Error Section Caption
Previous Name or Address Error Section Heading

Previous Name Information Section Caption
Previous Name Information Section Heading
PREVIOUS NAME

PNA Section Caption

PNA Section Heading

Previous Name Sub Section Caption
Previous Name Sub Section Heading
* Have you previously registered to vote in the United States under a name that is different than the name on this application?	Have you previously registered to vote in the United States under a name that is different than the name on this application? Yes No
* Did your name change due to a reason other than marriage or divorce?	Did your name change due to a reason other than marriage or divorce? Yes No

Previous Name Fields Section Caption
Previous Name Fields Section Heading
Reason for Name Change: *
Previous First Name: *
Previous Middle Name:
Previous Last Name: *
Previous address

Previous Address Section Caption
Previous Name Fields Section Heading
* Have you previously registered to vote in the United States at an address that is different than the residential address on this application?	Have you previously registered to vote in the United States at an address that is different than the residential address on this application? Yes No

Previous Address Fields Section Caption
Previous Name Fields Section Heading
If Yes, please enter as much information as you remember about the address used on your last voter registration. The information you provide allows us to notify the previous jurisdiction so they may cancel your registration
Previous Street Number:
Previous Street Name:
Previous Address Line 2:
Previous Apartment Number:
Previous City:
Previous State:
Previous Zip Code (First 5 digits):
Previous County: County

Final Declarations

Fields marked with * are required fields

Final Declaration Help Section Caption
Final Declaration Help Section Heading

Final Declaration Error Section Caption
Final Declaration Error Section Heading

Final Declarations Section Caption

Final Declarations Section Heading

Please reconfirm that you meet the following requirements to vote:

Final Declaration Reconfirmation Section Caption
Final Declaration Reconfirmation Section Heading
●	I am a citizen of the United States.
●	I am a resident of the State of Tennessee.
●	I will be 18 years of age or older on or before Election Day.
●	I have never been convicted of a crime which is a felony in this state, by a court in this state, a court in another state, or a federal court.
●	I understand that voter registration records are public records, open to inspection by any citizen of Tennessee, excluding the social security number, driver's license number and the Department of Safety and Homeland Security ID. Number.
●	I understand that giving false information to register to vote or attempting to register when not qualified is a felony punishable by not less than two (2) years nor more than twelve (12) years imprisonment or a fine of $5,000 or both.

* I confirm that I meet the above requirements to vote.

Review & Submit

Review Help Section Caption
Review Help Section Heading

Review Error Section Caption
Review Error Section Heading

Review and/or Edit Voter Information

Review Voter Information Caption

Review and/or Edit Voter Information Heading

Voter Eligibility

Review Voter Declaration Section Caption
Review Voter Declaration Section Heading
●	Are you a citizen of the United States?
●	Are you a resident of the State of Tennessee?
●	Will you be 18 years of age or older on or before Election Day?
●	Have you ever been convicted of a crime which is a felony in this state, by a court in this state, a court in another state, or a federal court?
●	I understand that voter registration records are public records, open to inspection by any citizen of Tennessee, excluding the social security number, driver’s license number, and the Department of Safety
●	I understand that giving false information to register to vote or attempting to register when not qualified is a felony punishable by not less than two (2) years nor more than twelve (12) years imprisonment or a fine of $5,000 or both

Voter Information

Review Personal Identifiable Information Caption
Review Personal Identifiable Information Section Heading
●	Registration Type
●	First Name
●	Middle Name
●	Last Name
●	Suffix
●	Date of Birth
●	Social Security Number
●	Driver’s License/Department of Safety and Homeland Security ID
●	I consent to the use of the information on this page for obtaining my digital signature from the Department of Safety and Homeland Security and I consent to using the obtained signature for my voter registration

Citizenship

Review Citizenship Caption
Review Citizenship Section Heading
●	Date of U.S. Citizenship
●	Naturalization Number

Additional Information

Review Additional Personal Information Section Caption
Review Additional Personal Information Section Heading
●	State of Birth
●	Country of Birth
●	City of Birth
●	Gender
●	(Optional) Race
●	(Optional) Phone Number
●	Re-Enter Phone Number
●	(Optional ) Email
●	Re-Enter Email
●	Are you interested in working on Election Day?

Address

RESIDENTIAL ADDRESS

Review Residential Address Section Caption
Review Residential Address Section Heading
●	County
●	Street Number
●	Street Name
●	Address Line 2
●	Apartment Number
●	City
●	State
●	Zip Code (First 5 digits)
●	Zip Code (Last 4 digits)
●	I, being duly sworn on oath (or affirmation) declare that the above address is my legal residence and that I plan to remain at such residence for an undetermined period of time and say that to the best of my knowledge and belief, all the statements made by me are true
●	MAILING ADDRESS SAME AS RESIDENCE

MAILING ADDRESS

Review Mailing Address Section Caption
Review Mailing Address Section Heading
●	Is your mailing address overseas?
●	Is your mailing address a PO Box?
●	Street Number
●	Street Name
●	Address Line 2
●	Apartment Number
●	City
●	State
●	Zip Code (First 5 digits)
●	Zip Code (Last 4 digits)

Review Overseas Mailing Address Section Caption
Review Overseas Mailing Address Section Heading
●	Is your mailing address overseas?
●	Street Name/Number/P.O. Box
●	Address Line 2
●	City/Town, Municipal Sub Division Postal Code
●	Country

Previous Information

Review Previous Name or Address Section Caption
Review Previous Name or Address Section Heading
●	Have you previously registered to vote in the United States under a name that is different than the name on this application?
●	Did your name change due to a reason other than marriage or divorce?
●	Reason for Name Change
●	Previous First Name
●	Previous Middle Name
●	Previous Last Name
●	Have you previously registered to vote in the United States at an address that is different than the residential address on this application?
●	Previous Street Number
●	Previous Street Name
●	Previous Apartment Number
●	Previous Address Line 2
●	Previous City
●	Previous State
●	Previous Zip Code
●	Previous County

Final Declarations

Review Confirmation Section Caption
Review Confirmation Section Heading
●	I confirm that I meet the above requirements to vote

Review Final Declaration Section Caption
Review Final Declaration Section Heading
Submit Voter Registration Application
Your application has not been submitted until you click submit

Application Submitted Confirmation

Application Submitted Confirmation Section Caption

Application Submitted Confirmation Section Heading

Thank you for completing your voter registration application

You are not registered to vote until your County Election office has processed your application. If you are qualified and the information on your form is complete, you will be added to the county's voter rolls. The County Election Commission will then mail you a voter registration card. This card will tell you where to vote.

Once your voter registration is processed, you can use the GoVoteTN app to view sample ballots, locate polling locations, and learn about your district.

All voters must present a federal or Tennessee state ID containing the voter’s name and photograph when voting at the polls, whether voting early or on Election Day unless an exemption applies. For more information about Tennessee’s photo ID law, click here.

EXIT - or - PRINT/SAVE APPLICATION EMAIL APPLICATION FOR YOUR RECORDS

Voter Registration Application Summary:

Voter Registration Summary Section Caption
Voter Registration Summary Section Heading
Name	:
Transaction ID	:
Submission Date/Time (CST)	:	CST

Please provide your email address to send this application.

Your application will expire in 3 minutes if no further action is taken.

1

2

3

4

5

6

7

8

9

Voter Eligibility

Voter Information

VOTER REGISTRATION TYPE

PERSONAL INFORMATION

Citizenship Information

Additional Personal Information

Registration and Mailing Address

RESIDENTIAL ADDRESS

Name and Address On Your Last Voter Registration Record

PREVIOUS NAME

Previous address Last Address where you registered to vote

Final Declarations

Review & Submit

Review and/or Edit Voter Information

RESIDENTIAL ADDRESS

MAILING ADDRESS

Submit Voter Registration Application

Application Submitted Confirmation

­

Previous address