Homecare worker orientation., January 01, 2005, 4th Edition, Image 9

Instructions
how to register to vote
you may use this form to:
selecting a political party
Use blue or black ink to fill out the form.
Register to vote in Oregon.
Some political parties require you to
Sign the form.
Change your name, mailing address,
be registered in their party to vote for their
candidates in a primary election.
Mail the completed form to your county.
residence address or political party affiliation
Do not fax!
on your voter registration.
If the form is incomplete, it may be rejected.
If you fax this form, it will not be accepted.
Become eligible to sign petitions, including
initiative, referendum and recall petitions.
Addresses are online at
www.sos.state.or.us/elections/other.info/clerk.htm
PLEASE NOTE: Because you are returning this
form to SEIU Local 503, ID is not required.
Your county elections office Will mail you a card
to let you know that your registration was received.
Oregon Voter Registration
qualifications
SEL 500bw rev. 12/03
If you check no in response to either of these questions, do not complete this form.
Are you a citizen of the United States of America^?
Qyes
Ono
Will you be at least 18 years of age on or before election day?
Qyes
Ono
personal information
please print
first
middle
home address (required, include apt. or space number)
city
zip code
date of birth (required, month/day/year)
phone number (optional)
county of residence
name (required)
last
mailing address (required if different from home address)
political party
choose one of the following:
QConstitution
o Democratic
QLibertarian
O^ePublican
ONot a member of a party
QOther_
O^30'^0 Green
signature I swear or affirm that I am qualified to be an elector, and I have told the truth on this registration.
sign here
_______ â_________________________ _______________ date today
warning: If you sign this card and know it to be false, you can be fined up to $100,000 and/or jailed for up to 5 years.
identification
with mailed registration only
Identification is requested only if you are a new registrant in this county and are mailing this form via
the United States Postal Service. Identification is not required for updates within the same county or new
registrations delivered in person or by means other than mail.
Sufficient identification is a copy of one of the following showing your current name and address:
valid photo identification (such as a driver's license)
a paycheck stub
a utility bill
a bank statement
a government document
if previously registered and changing personal information, fill out this section
please print
previous registration name
previous county and state
home address on previous registration
date of birth (month/day/year)