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Wyoming Voter Registration Application Form

In order to qualify for voting in the State of Wyoming or to change registered information such as the party, name, and address, you are required to complete the Wyoming Voter Registration Application form.

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INSTRUCTIONS FOR COMPLETING & SUBMITTING  
VOTER REGISTRATION 
APPLICATION FORM  Y
OU  MAY  USE THIS FORM TO :  R EGISTER TO VOTE IN  WYOMING OR TO CHANGE  YOUR REGISTRATION (NAME , ADDRESS OR PARTY )    
   	Register at the  county clerk’s office :   	Print out the form & sign i
t in front of any registry agent.  
     Register by mail:   	
Voters who are not currently in Wyoming
 	or who cannot go to the County C lerk's 
office may register by mail. 
Follow the instructions below to  mail in your voter registration application :    1. 
Print out the voter registration form and f ill it out in front of  a notary or  person authorized to 
administer oaths
.	
   Print clearly, using a black or blue ink pen (not felt tip).  2. 
Show identification to the notary or registry agen t.  See list of acceptable documents below:  Preferred 
identification   Second option if you do n’t have 
valid  Wyoming driver’s license   Third option:  2 of   any of    the following 
documents  
Valid  Wyoming 
driver’s license   Dif ferent state’s driver’s license;  
ID issued by a local, state or 
federal agency; U . S .   passport; 
school ID; military ID   Certificate   of US citizenship or naturalization; 
draft record; voter registration card from another 
state or county; original or certified copy of birth 
certificate bearing an official seal; certificate of 
birth abroad issued by U.S. State Department; any 
other form  of ID issued by an official agency  
3. 
Sign the voter registration oath  	
on the form 	and have the notary or registered agent sign the form.   4. 
Make copies of the identification documents  you showed 	
to the notary.   5. 
Mail  	
the voter registration form ,	 along with the 	copies of your 	ID documents ,	 to your County Clerk .    
Note:  Sending your form to any other office will delay your voter registration.
  	
 6. 
Mail your form as soon as possible.   Voter  registration closes two weeks prior to an election .  
  7. 
Follow up with your County C lerk about any questions you may have  about  your registration or requests for 
absentee ballots. 
 	
See   http://soswy.state.wy.us/Elections/CountyClerks.aspx   for contact details.  
  
  W Y O M I N G   C O U N T Y   C L E R K S  
Albany County Clerk 
 
525 Grand Ave, Ste 202  Laramie, WY  82070
  Hot Springs County Clerk  
415 Arapahoe  
Thermopolis, WY   82443 - 2783   Sheridan County Clerk  
224 S Main St, Ste 17  
Sheridan, WY  82801 - 4855  
Big Horn County Clerk    
County  Courthouse, PO Box 31  
Basin, WY  82410 - 0031   Johnson County Clerk  
76 N Main St  
Buffalo, WY  82834 - 1883   Sublette County Clerk  
PO Box 250  
Pinedale, WY  82941 - 0250  
Campbell County Clerk  
PO Box 3010  
Gillette, WY  82717 - 3010   Laramie County Clerk    
PO Box 608  
Cheyenne, WY  82003 - 0608   Sweetwater County Clerk  
80 W Flaming Gorge Way, Ste 155  
Green River, WY  82935  
Carbon County Clerk  
PO Box 6  
Rawlins, WY  82301 - 0006   Lincoln County Clerk  
J925 Sage Ave, Ste 101  
Kemmerer, WY  83101   Teton County Clerk  
PO Box 1727  
Jackson, WY  83001 - 1727  
 
Converse County Clerk  
107 N 5th St, Ste 114  
Douglas, WY  82633 - 2448   Natrona County Clerk  
PO Box 863  
Casper, WY  82601 - 0863    
Uinta County Clerk  
PO Box 810  
Evanston, Wy  82930 - 0810   
 
Crook County Clerk  
PO Box 37  
Sundance, WY   82729 - 0037   Niobrara County Clerk  
PO Box 420  
Lusk, WY  82225 - 0420   Washakie County Clerk  
1001 Big Horn Ave  
PO Box 260  
Worland, WY  82401  
Fremont County Clerk  
450 N 2nd St, Rm 220  
Lander, Wy  82520 - 0090   Park County Clerk  
1002 Sheridan  
Cody, WY  82414 - 3589   Weston County Clerk  
1 W Main  
Newcastle, WY  82701 - 2121  
Goshen County Clerk  
PO Box 160  
Torrington, WY  82240 - 0160   Platte County Clerk  
PO Drawer 728  
Wheatland, WY  82201 - 0728  
   OR

3/2014 VR # ___________________   County # ________  
District _________   Precinct _________   Split __________  
School __________  House __________   Senate_________  
Municipality __________    Ward ____________  Wyoming Voter Registration Application & Change Form 
 
  New   Voter Application     Chang e   to Current Registration  
 
 
  N ame  Change    
 
   1 .  Name and Date of Birth  
Legal   
Last Name   Legal   
First Name   Legal   
Middle Name   Suffix  
Date   
of Birth   County   
Resident S ince          
 
2.   Wyoming   Driver’s L icense       You must provide this number if you hold a valid Wyoming   Driver’s L icense  
Valid Wyoming Driver’s License Number:  
    Mark here only if you  do not have   a valid Wyoming Driver’s License and go to step 2a.  
  2a .   Social Security N umber       Last four digits are required if you do not have a   valid Wyoming   Driver’s L icense  
  Social Security   Number  
    Mark here only if you  do not have   a valid Wyoming Driver’s License  or   a Social Security N umber.     
 
3 .  Personal I nformation    * Denotes optional information  
Gender*          Male  
                        Female   Wyoming Residence  Address (No P.O. Box Numbers)   City   Zip  
Address Where Y ou   
Get Your M ail   Mailing   
City   State   Zip  
Phone*   Are you interested in being an Election Judge?*         Yes        No  
E - m ail*   Do you need assistance to vote? *                               Yes         No  
 
   4. Political Party        
Choose one of the following                                                  Republican                     Democratic                   Libertarian                     Constitution                  Unaffiliated      
 
5 .   C hange s   to  C urrent Wyoming  Voter R egistration    
Former Wyoming  Residence  
Street Address   City   WY County   State  
Wyoming   Zip  
Former   
Last Name    Former   
First Name   Former   
Middle Name   Suffix  
  5 a.  Withdrawal of  V oter  Registration from A nother S tate      Residence address in p rior S tate  
  Street Address                                                                            City   County   State   Zip  
 
6 .   R egistration Oath and  A cknowledgement         Required on all applications.  
I do solemnly swear (or affirm) that I am a citizen of the United States; that I am a bona fide resident of the state of Wyom ing and this county;  that if registered in 
another county or state, I hereby request that my registration be withdrawn;  that I will be at least eighteen (18) years of age on or before the next election; that I 
am not currently adjudicated a mentally incompetent person; that I  have not been convicted of a felony, or if I have been convicted of a felony, I have had my civil 
or voting rights restored by a competent authority; and that the voter registration information contained herein is true and  accurate to my best knowledge and  
belief.  
 
Sign yo ur legal name  
  in full      
  Proof of Identification Shown   Type of Identification  
Subscribed and affirmed or sworn to before me by    
______________________________________ ___________________ _   (n ame of  a pplicant )     on  ____________________________   (a pplication  d ate )  
 
Signature  & Title  of Registry Agent or 
person authorized to administer oaths    
  Title
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