State/Public Agencies - Requesting Voter Registration Forms By Mail - Elections & Voting

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Please use the Voter Registration Request Form. The form below is intended only for State and Public Agencies.

State Agency *

DSHS – Community Services Division (CSD)

DSHS – Aging & Long-Term Support Admin. (ALTSA)

DSHS – Developmental Disabilities Admin. (DDA)

DSHS – Division of Vocational Rehabilitation (DVR)

Dept. of Health (DOH)

Health Care Authority (HCA)

Health Benefits Exchange (HBE)

Dept. of Services for the Blind (DSB)

Other Agency

Specify agency

Contact name *

Mailing address *

City *

State *

Zip *

Email *

Phone *

Number of Voter Registration Forms

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