Title is required.
Use your full first name. Do not use nicknames or initials.
This field is required.
optional
You must be a U.S. citizen to register

Previous Name

Title is required.
Use your full first name. Do not use nicknames or initials.
This field is required.
optional
Put your home address in these boxes. Do not put your mailing address here if it is different from your home address. Do not use a post office box or rural route without a box number. If you live in a rural area but do not have a street address, or if you have no address, please show where you live using the map on the printed form.
Not in HI?
Enter a valid 5 digit zip code.
If you receive mail at a different address, please enter it here.
Enter a valid 5 digit zip code.
If you have moved since your last registration, enter your previous address.
Enter a valid 5 digit zip code.
Your full social security number is required. It is used to prevent fraudulent registration and voting. Failure to furnish this information will prevent acceptance of this application.
Enter your birthdate in MM/DD/YYYY format.
Enter a phone number in xxx-xxx-xxxx format.
You do not have to register with a political party to register to vote.
The state of Hawaii does not require information about your race or ethnicity. However, Rock the Vote would appreciate this information in order to measure the effectiveness of our voter registration efforts. This information will NOT appear on your printed voter registration form.

Survey Questions (optional)

Optional
Optional