Board of Elections Data Request Form Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* What type of data are you looking for?* Select All Voter Registration Report Voter History Report Statistics Report Campaign Finance Report Jurisdiction Maps Other Which of the following fields would you like included in your report?*NOTE: Number of fields will affect the font size of the printout Select All Voter Registration Number Name Status Party Affiliation Registration Date Gender Ethnicity Race Age Residential Address Mailing Address Telephone Precinct Municipality School Board District How would you like your report grouped/sorted?* Sort Alphabetically by last name Sort by Precinct Other (specify in comment field below) In what format would you like to receive your data?* Printout ($.25 for first page + $.05 for each additional page) Compact Disc ($25.00) Email (Free—specify format in comment field below) Labels ($.50 per page) Comments This iframe contains the logic required to handle Ajax powered Gravity Forms.