CINXE.COM

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html lang="en"> <head><script type="text/javascript" src="/_static/js/bundle-playback.js?v=HxkREWBo" charset="utf-8"></script> <script type="text/javascript" src="/_static/js/wombat.js?v=txqj7nKC" charset="utf-8"></script> <script>window.RufflePlayer=window.RufflePlayer||{};window.RufflePlayer.config={"autoplay":"on","unmuteOverlay":"hidden"};</script> <script type="text/javascript" src="/_static/js/ruffle/ruffle.js"></script> <script type="text/javascript"> __wm.init("https://web.archive.org/web"); __wm.wombat("https://absentee.vote.org/?campaign=vip-home-page","20200930224606","https://web.archive.org/","web","/_static/", "1601505966"); </script> <link rel="stylesheet" type="text/css" href="/_static/css/banner-styles.css?v=S1zqJCYt" /> <link rel="stylesheet" type="text/css" href="/_static/css/iconochive.css?v=3PDvdIFv" />  <title> Get Your Absentee Ballot - Vote.org </title> <meta name="csrf-param" content="authenticity_token"/> <meta name="csrf-token" content="J6hRyt6+M/ktvbZDAgemrDyVgUVkSIItEmxYVjic2HOEiFayjDHJcM8fxJrGwZJyNDu8GhvtDyINPSnMIe/Ahw=="/> <meta charset="utf-8"/> <script>window.NREUM||(NREUM={});NREUM.info={"beacon":"bam.nr-data.net","errorBeacon":"bam.nr-data.net","licenseKey":"3d18fef3ed","applicationID":"117732748","transactionName":"cw4LFhcJWV4DQR4RQ1UTFk0LA0I=","queueTime":3,"applicationTime":9,"agent":""}</script> <script>(window.NREUM||(NREUM={})).loader_config={licenseKey:"3d18fef3ed",applicationID:"117732748"};window.NREUM||(NREUM={}),__nr_require=function(e,t,n){function r(n){if(!t[n]){var i=t[n]={exports:{}};e[n][0].call(i.exports,function(t){var i=e[n][1][t];return r(i||t)},i,i.exports)}return t[n].exports}if("function"==typeof __nr_require)return __nr_require;for(var i=0;i<n.length;i++)r(n[i]);return r}({1:[function(e,t,n){function r(){}function i(e,t,n){return function(){return o(e,[u.now()].concat(c(arguments)),t?null:this,n),t?void 0:this}}var o=e("handle"),a=e(6),c=e(7),f=e("ee").get("tracer"),u=e("loader"),s=NREUM;"undefined"==typeof window.newrelic&&(newrelic=s);var d=["setPageViewName","setCustomAttribute","setErrorHandler","finished","addToTrace","inlineHit","addRelease"],p="api-",l=p+"ixn-";a(d,function(e,t){s[t]=i(p+t,!0,"api")}),s.addPageAction=i(p+"addPageAction",!0),s.setCurrentRouteName=i(p+"routeName",!0),t.exports=newrelic,s.interaction=function(){return(new r).get()};var m=r.prototype={createTracer:function(e,t){var n={},r=this,i="function"==typeof t;return o(l+"tracer",[u.now(),e,n],r),function(){if(f.emit((i?"":"no-")+"fn-start",[u.now(),r,i],n),i)try{return t.apply(this,arguments)}catch(e){throw f.emit("fn-err",[arguments,this,e],n),e}finally{f.emit("fn-end",[u.now()],n)}}}};a("actionText,setName,setAttribute,save,ignore,onEnd,getContext,end,get".split(","),function(e,t){m[t]=i(l+t)}),newrelic.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),o("err",[e,u.now(),!1,t])}},{}],2:[function(e,t,n){function r(){return c.exists&&performance.now?Math.round(performance.now()):(o=Math.max((new Date).getTime(),o))-a}function i(){return o}var o=(new Date).getTime(),a=o,c=e(8);t.exports=r,t.exports.offset=a,t.exports.getLastTimestamp=i},{}],3:[function(e,t,n){function r(e,t){var n=e.getEntries();n.forEach(function(e){"first-paint"===e.name?d("timing",["fp",Math.floor(e.startTime)]):"first-contentful-paint"===e.name&&d("timing",["fcp",Math.floor(e.startTime)])})}function i(e,t){var n=e.getEntries();n.length>0&&d("lcp",[n[n.length-1]])}function o(e){e.getEntries().forEach(function(e){e.hadRecentInput||d("cls",[e])})}function a(e){if(e instanceof m&&!g){var t=Math.round(e.timeStamp),n={type:e.type};t<=p.now()?n.fid=p.now()-t:t>p.offset&&t<=Date.now()?(t-=p.offset,n.fid=p.now()-t):t=p.now(),g=!0,d("timing",["fi",t,n])}}function c(e){d("pageHide",[p.now(),e])}if(!("init"in NREUM&&"page_view_timing"in NREUM.init&&"enabled"in NREUM.init.page_view_timing&&NREUM.init.page_view_timing.enabled===!1)){var f,u,s,d=e("handle"),p=e("loader"),l=e(5),m=NREUM.o.EV;if("PerformanceObserver"in window&&"function"==typeof window.PerformanceObserver){f=new PerformanceObserver(r);try{f.observe({entryTypes:["paint"]})}catch(v){}u=new PerformanceObserver(i);try{u.observe({entryTypes:["largest-contentful-paint"]})}catch(v){}s=new PerformanceObserver(o);try{s.observe({type:"layout-shift",buffered:!0})}catch(v){}}if("addEventListener"in document){var g=!1,y=["click","keydown","mousedown","pointerdown","touchstart"];y.forEach(function(e){document.addEventListener(e,a,!1)})}l(c)}},{}],4:[function(e,t,n){function r(e,t){if(!i)return!1;if(e!==i)return!1;if(!t)return!0;if(!o)return!1;for(var n=o.split("."),r=t.split("."),a=0;a<r.length;a++)if(r[a]!==n[a])return!1;return!0}var i=null,o=null,a=/Version\/(\S+)\s+Safari/;if(navigator.userAgent){var c=navigator.userAgent,f=c.match(a);f&&c.indexOf("Chrome")===-1&&c.indexOf("Chromium")===-1&&(i="Safari",o=f[1])}t.exports={agent:i,version:o,match:r}},{}],5:[function(e,t,n){function r(e){function t(){e(a&&document[a]?document[a]:document[i]?"hidden":"visible")}"addEventListener"in document&&o&&document.addEventListener(o,t,!1)}t.exports=r;var i,o,a;"undefined"!=typeof document.hidden?(i="hidden",o="visibilitychange",a="visibilityState"):"undefined"!=typeof document.msHidden?(i="msHidden",o="msvisibilitychange"):"undefined"!=typeof document.webkitHidden&&(i="webkitHidden",o="webkitvisibilitychange",a="webkitVisibilityState")},{}],6:[function(e,t,n){function r(e,t){var n=[],r="",o=0;for(r in e)i.call(e,r)&&(n[o]=t(r,e[r]),o+=1);return n}var i=Object.prototype.hasOwnProperty;t.exports=r},{}],7:[function(e,t,n){function r(e,t,n){t||(t=0),"undefined"==typeof n&&(n=e?e.length:0);for(var r=-1,i=n-t||0,o=Array(i<0?0:i);++r<i;)o[r]=e[t+r];return o}t.exports=r},{}],8:[function(e,t,n){t.exports={exists:"undefined"!=typeof window.performance&&window.performance.timing&&"undefined"!=typeof window.performance.timing.navigationStart}},{}],ee:[function(e,t,n){function r(){}function i(e){function t(e){return e&&e instanceof r?e:e?f(e,c,o):o()}function n(n,r,i,o){if(!p.aborted||o){e&&e(n,r,i);for(var a=t(i),c=v(n),f=c.length,u=0;u<f;u++)c[u].apply(a,r);var d=s[w[n]];return d&&d.push([b,n,r,a]),a}}function l(e,t){h[e]=v(e).concat(t)}function m(e,t){var n=h[e];if(n)for(var r=0;r<n.length;r++)n[r]===t&&n.splice(r,1)}function v(e){return h[e]||[]}function g(e){return d[e]=d[e]||i(n)}function y(e,t){u(e,function(e,n){t=t||"feature",w[n]=t,t in s||(s[t]=[])})}var h={},w={},b={on:l,addEventListener:l,removeEventListener:m,emit:n,get:g,listeners:v,context:t,buffer:y,abort:a,aborted:!1};return b}function o(){return new r}function a(){(s.api||s.feature)&&(p.aborted=!0,s=p.backlog={})}var c="nr@context",f=e("gos"),u=e(6),s={},d={},p=t.exports=i();p.backlog=s},{}],gos:[function(e,t,n){function r(e,t,n){if(i.call(e,t))return e[t];var r=n();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:r,writable:!0,enumerable:!1}),r}catch(o){}return e[t]=r,r}var i=Object.prototype.hasOwnProperty;t.exports=r},{}],handle:[function(e,t,n){function r(e,t,n,r){i.buffer([e],r),i.emit(e,t,n)}var i=e("ee").get("handle");t.exports=r,r.ee=i},{}],id:[function(e,t,n){function r(e){var t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===window?0:a(e,o,function(){return i++})}var i=1,o="nr@id",a=e("gos");t.exports=r},{}],loader:[function(e,t,n){function r(){if(!E++){var e=b.info=NREUM.info,t=p.getElementsByTagName("script")[0];if(setTimeout(u.abort,3e4),!(e&&e.licenseKey&&e.applicationID&&t))return u.abort();f(h,function(t,n){e[t]||(e[t]=n)});var n=a();c("mark",["onload",n+b.offset],null,"api"),c("timing",["load",n]);var r=p.createElement("script");r.src="https://"+e.agent,t.parentNode.insertBefore(r,t)}}function i(){"complete"===p.readyState&&o()}function o(){c("mark",["domContent",a()+b.offset],null,"api")}var a=e(2),c=e("handle"),f=e(6),u=e("ee"),s=e(4),d=window,p=d.document,l="addEventListener",m="attachEvent",v=d.XMLHttpRequest,g=v&&v.prototype;NREUM.o={ST:setTimeout,SI:d.setImmediate,CT:clearTimeout,XHR:v,REQ:d.Request,EV:d.Event,PR:d.Promise,MO:d.MutationObserver};var y=""+location,h={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",agent:"js-agent.newrelic.com/nr-1184.min.js"},w=v&&g&&g[l]&&!/CriOS/.test(navigator.userAgent),b=t.exports={offset:a.getLastTimestamp(),now:a,origin:y,features:{},xhrWrappable:w,userAgent:s};e(1),e(3),p[l]?(p[l]("DOMContentLoaded",o,!1),d[l]("load",r,!1)):(p[m]("onreadystatechange",i),d[m]("onload",r)),c("mark",["firstbyte",a.getLastTimestamp()],null,"api");var E=0},{}],"wrap-function":[function(e,t,n){function r(e){return!(e&&e instanceof Function&&e.apply&&!e[a])}var i=e("ee"),o=e(7),a="nr@original",c=Object.prototype.hasOwnProperty,f=!1;t.exports=function(e,t){function n(e,t,n,i){function nrWrapper(){var r,a,c,f;try{a=this,r=o(arguments),c="function"==typeof n?n(r,a):n||{}}catch(u){p([u,"",[r,a,i],c])}s(t+"start",[r,a,i],c);try{return f=e.apply(a,r)}catch(d){throw s(t+"err",[r,a,d],c),d}finally{s(t+"end",[r,a,f],c)}}return r(e)?e:(t||(t=""),nrWrapper[a]=e,d(e,nrWrapper),nrWrapper)}function u(e,t,i,o){i||(i="");var a,c,f,u="-"===i.charAt(0);for(f=0;f<t.length;f++)c=t[f],a=e[c],r(a)||(e[c]=n(a,u?c+i:i,o,c))}function s(n,r,i){if(!f||t){var o=f;f=!0;try{e.emit(n,r,i,t)}catch(a){p([a,n,r,i])}f=o}}function d(e,t){if(Object.defineProperty&&Object.keys)try{var n=Object.keys(e);return n.forEach(function(n){Object.defineProperty(t,n,{get:function(){return e[n]},set:function(t){return e[n]=t,t}})}),t}catch(r){p([r])}for(var i in e)c.call(e,i)&&(t[i]=e[i]);return t}function p(t){try{e.emit("internal-error",t)}catch(n){}}return e||(e=i),n.inPlace=u,n.flag=a,n}},{}]},{},["loader"]);</script> <meta content="width=device-width, initial-scale=1.0" name="viewport"/> <meta content="Get Your Absentee Ballot - Vote.org" property="og:title"/> <meta content="It takes 2 minutes to get your absentee ballot. Get started now." property="og:description"/> <meta content="VOTE.org" property="og:site_name"/> <meta content="https://web.archive.org/web/20200930224606im_/https://images.vote.org/og-absentee.jpg" property="og:image"/> <meta content="https://web.archive.org/web/20200930224606/https://www.vote.org/absentee-ballot/" property="og:url"/> <link href="https://web.archive.org/web/20200930224606/https://www.vote.org/absentee-ballot/" rel="canonical"/> <link href="https://web.archive.org/web/20200930224606im_/https://images.vote.org/favicon.ico" rel="icon" type="image/png"/> <link crossorigin="anonymous" href="https://web.archive.org/web/20200930224606cs_/https://use.fontawesome.com/releases/v5.1.0/css/all.css" integrity="" rel="stylesheet"/> <link rel="stylesheet" media="screen" href="/web/20200930224606cs_/https://absentee.vote.org/assets/application-0ac72687cdf5536ede7fc17a59ec3fe2.css"/> <script> (function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){ (i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o), m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m) })(window,document,'script','https://web.archive.org/web/20200930224606/https://www.google-analytics.com/analytics.js','ga'); /* Create absentee account tracker */ ga('create', 'UA-51700780-1', 'auto'); ga('set', 'dimension1', '8c451ee8-e0e1-4e93-8f68-82fc74321965'); ga('require', 'displayfeatures'); ga('send', 'pageview'); </script> <script src="https://web.archive.org/web/20200930224606js_/https://cdn.ravenjs.com/2.3.0/raven.min.js"></script> <script> Raven.config("https://web.archive.org/web/20200930224606/https://1caee4f7072143359cf42f9fd785efd2@sentry.io/72410").install({ shouldSendCallback: function(data) { // disable sentry reporting for totally broken browsers if (window.jQuery === undefined) { return false; } if ($('body').children('.ldv-lt-ie9').length) { return false; } return true; } }); </script> <script src="/web/20200930224606js_/https://absentee.vote.org/assets/application-f186ca04ba77059c54b622a5f48e0a7d.js"></script> </head> <body>  <div class="page-container"> <header>  <div class="usa-grid text-center"> <div class="usa-width-one-whole"> <h1> Request Your Absentee Ballot </h1> <div class="vdo-tagline">This will take 2 minutes</div> </div> </div>  </header> <div class="form-container"> <div class="container"></div> <div class="fail-area usa-alert usa-alert-error hidden"> <div class="usa-alert-body"> <h3 class="usa-alert-heading"> Something went wrong. </h3> <div class="usa-alert-text"> <p> There was a problem generating your form. Please try again later. </p> </div> </div> </div> <form id="get_started_form" class="vote-org-form" role="form" action="choose_form" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"/><input type="hidden" name="authenticity_token" value="cf0W5tUgSWQZ+Eqpo5fdppiDlnn7vowy2l+m7krOXsPS3RGeh6+z7ftaOHBnUel4kC2rJoQbAT3FDtd0U71GNw=="/> <input type="hidden" name="partner" id="partner" value="999999"/> <input type="hidden" name="campaign" id="campaign" value="vip-home-page"/> <input type="hidden" name="no_header" id="no_header"/> <input type="hidden" name="header_color" id="header_color"/> <input type="hidden" name="header_font_color" id="header_font_color"/> <div> <fieldset class="hide-legend"> <div class="usa-grid"> <legend>Name</legend> </div> <div class="usa-grid"> <div class="usa-width-one-half"> <label for="first_name">First name <em>*</em></label> <input type="text" name="first_name" id="first_name" required="required"/> </div> <div class="usa-width-one-half"> <label for="last_name">Last name <em>*</em></label> <input type="text" name="last_name" id="last_name" required="required"/> </div> </div> </fieldset> <fieldset> <div class="usa-grid"> <legend>Where are you registered to vote?</legend> </div> <div class="usa-grid"> <div class="usa-width-three-fourths"> <label for="street_address">Street address <em>*</em></label> <input type="text" name="street_address" id="street_address" required="required" autocomplete="do-not-autocomplete"/> </div> <div class="usa-width-one-fourth"> <label for="unit_number">Apartment</label> <input type="text" name="unit_number" id="unit_number" autocomplete="address-line2"/> </div> </div> <div class="usa-grid"> <div class="usa-width-one-half"> <label for="city">City <em>*</em></label> <input type="text" name="city" id="city" required="required" autocomplete="address-level2"/> </div> <div class="usa-width-one-fourth"> <label for="state">State <em>*</em></label> <select name="state" id="state" required="required" autocomplete="address-level1"><option value=""></option><option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option></select> </div> <div class="usa-width-one-fourth"> <label for="zip_5">ZIP code <em>*</em></label> <input type="number" name="zip_5" id="zip_5" required="required" autocomplete="postal-code"/> </div> </div> </fieldset> <fieldset class="hide-legend"> <div class="usa-grid"> <legend>Date of birth</legend> </div> <div class="usa-grid"> <label for="date_of_birth">Date of birth <em>*</em></label> <div class="usa-width-one-half" id="date_of_birth"> <label class="hidden" for="date_of_birth_month">Birth month</label> <select name="date_of_birth_month" id="date_of_birth_month" required="required"><option value=""></option><option value="1">January</option> <option value="2">February</option> <option value="3">March</option> <option value="4">April</option> <option value="5">May</option> <option value="6">June</option> <option value="7">July</option> <option value="8">August</option> <option value="9">September</option> <option value="10">October</option> <option value="11">November</option> <option value="12">December</option></select> </div> <div class="usa-width-one-fourth"> <label class="hidden" for="date_of_birth_day">Birth day</label> <select name="date_of_birth_day" id="date_of_birth_day" required="required"><option value=""></option><option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> <option value="13">13</option> <option value="14">14</option> <option value="15">15</option> <option value="16">16</option> <option value="17">17</option> <option value="18">18</option> <option value="19">19</option> <option value="20">20</option> <option value="21">21</option> <option value="22">22</option> <option value="23">23</option> <option value="24">24</option> <option value="25">25</option> <option value="26">26</option> <option value="27">27</option> <option value="28">28</option> <option value="29">29</option> <option value="30">30</option> <option value="31">31</option></select> </div> <div class="usa-width-one-fourth"> <label class="hidden" for="date_of_birth_year">Birth year</label> <select name="date_of_birth_year" id="date_of_birth_year" required="required"><option value=""></option><option value="2003">2003</option> <option value="2002">2002</option> <option value="2001">2001</option> <option value="2000">2000</option> <option value="1999">1999</option> <option value="1998">1998</option> <option value="1997">1997</option> <option value="1996">1996</option> <option value="1995">1995</option> <option value="1994">1994</option> <option value="1993">1993</option> <option value="1992">1992</option> <option value="1991">1991</option> <option value="1990">1990</option> <option value="1989">1989</option> <option value="1988">1988</option> <option value="1987">1987</option> <option value="1986">1986</option> <option value="1985">1985</option> <option value="1984">1984</option> <option value="1983">1983</option> <option value="1982">1982</option> <option value="1981">1981</option> <option value="1980">1980</option> <option value="1979">1979</option> <option value="1978">1978</option> <option value="1977">1977</option> <option value="1976">1976</option> <option value="1975">1975</option> <option value="1974">1974</option> <option value="1973">1973</option> <option value="1972">1972</option> <option value="1971">1971</option> <option value="1970">1970</option> <option value="1969">1969</option> <option value="1968">1968</option> <option value="1967">1967</option> <option value="1966">1966</option> <option value="1965">1965</option> <option value="1964">1964</option> <option value="1963">1963</option> <option value="1962">1962</option> <option value="1961">1961</option> <option value="1960">1960</option> <option value="1959">1959</option> <option value="1958">1958</option> <option value="1957">1957</option> <option value="1956">1956</option> <option value="1955">1955</option> <option value="1954">1954</option> <option value="1953">1953</option> <option value="1952">1952</option> <option value="1951">1951</option> <option value="1950">1950</option> <option value="1949">1949</option> <option value="1948">1948</option> <option value="1947">1947</option> <option value="1946">1946</option> <option value="1945">1945</option> <option value="1944">1944</option> <option value="1943">1943</option> <option value="1942">1942</option> <option value="1941">1941</option> <option value="1940">1940</option> <option value="1939">1939</option> <option value="1938">1938</option> <option value="1937">1937</option> <option value="1936">1936</option> <option value="1935">1935</option> <option value="1934">1934</option> <option value="1933">1933</option> <option value="1932">1932</option> <option value="1931">1931</option> <option value="1930">1930</option> <option value="1929">1929</option> <option value="1928">1928</option> <option value="1927">1927</option> <option value="1926">1926</option> <option value="1925">1925</option> <option value="1924">1924</option> <option value="1923">1923</option> <option value="1922">1922</option> <option value="1921">1921</option> <option value="1920">1920</option> <option value="1919">1919</option> <option value="1918">1918</option> <option value="1917">1917</option> <option value="1916">1916</option> <option value="1915">1915</option> <option value="1914">1914</option> <option value="1913">1913</option> <option value="1912">1912</option> <option value="1911">1911</option> <option value="1910">1910</option> <option value="1909">1909</option> <option value="1908">1908</option> <option value="1907">1907</option> <option value="1906">1906</option> <option value="1905">1905</option> <option value="1904">1904</option> <option value="1903">1903</option> <option value="1902">1902</option> <option value="1901">1901</option> <option value="1900">1900</option></select> </div> </div> </fieldset> <fieldset class="hide-legend last"> <div class="usa-grid"> <legend>Contact Info</legend> </div> <div class="usa-grid"> <div class="usa-width-one-half"> <label for="email">Email address <em>*</em></label> <input type="email" name="email" id="email" required="required"/> </div> <div class="usa-width-one-half"> <label for="phone_number">Cell phone number</label> <input type="tel" name="phone_number" id="phone_number"/> </div> </div> </fieldset> </div> <div class="usa-grid"> <div class="usa-width-one-whole"> <div class="submit-buttons-container"> <input type="submit" name="commit" value="Continue" class="usa-button usa-button-primary usa-button-big usa-button-width-medium" data-disable-with="Processing..."/> </div> </div> <div class="usa-width-one-whole"> <div class="submit-notice"> <p>You will receive occasional emails from Vote.org. You can unsubscribe at any time.</p> <p> You will receive recurring text messages from Vote.org at 22821 if you provide your cell phone number. Message and data rates may apply. Text STOP to opt out. Text HELP for more info. See <a href="https://web.archive.org/web/20200930224606/https://www.vote.org/privacy/" target="_blank" rel="noopener">privacy policy</a> and <a href="https://web.archive.org/web/20200930224606/https://www.vote.org/terms/" target="_blank" rel="noopener">terms of service</a>. </p> </div> </div> </div> </form><script src="https://web.archive.org/web/20200930224606js_/https://maps.googleapis.com/maps/api/js?key=AIzaSyCZwSE2BJBo7cnpgf1DIYsfguNzix3Uz44&libraries=places"></script> <script> var streetCopy = $('#street_address').clone(); function gm_authFailure() { originalStreet = $('#street_address') currentValue = originalStreet.val() streetCopy.val(currentValue); originalStreet.parent().append(streetCopy) originalStreet.remove() }; $(document).ready(function() { var autocompleteInitialized = false; $('#street_address').keyup(function(){ if(!autocompleteInitialized && $('#street_address').val().length === 2){ initAutocomplete(); autocompleteInitialized = true } }); // hack around autocomplete filling the whole address into one field $('#street_address').blur(function() { // put the value in the placeholder $('#street_address').attr('placeholder', $('#street_address').val()); // style the placeholder to look like the regular text $('#street_address').addClass('autocompleting'); // save this to put it back in the value for users not autocompleting var streetVal = $('#street_address').val(); // empty out the value to show the placeholder $('#street_address').val(''); // white out the value if the user is autocompleting $('#street_address').css('color', 'white'); // non-autocomplete users: show the value again in .2 seconds // autocoplete users have the value shown once it's ready setTimeout(function() { if ($('#street_address').val() === '') { $('#street_address').removeClass('autocompleting'); $('#street_address').css('color', '#323a45'); $('#street_address').val(streetVal); } }, 200) }) }); function initAutocomplete() { autocomplete = new google.maps.places.Autocomplete( document.getElementById('street_address'), { types: ['address']}) autocomplete.setComponentRestrictions( {'country': ['us']}); // update the other fields once autocomplete is finished autocomplete.addListener('place_changed', fillInAddress) // more hacks: chrome autofill does not respect autocomplete="off" $('#street_address').keypress(function() { $('#street_address').attr('autocomplete', 'do-not-autocomplete') }) } function fillInAddress() { // Get the place details from the autocomplete object. var place = autocomplete.getPlace() // remap from: // [ {short_name: '123', types: ['street_number'] }, ... ] // to: // { street_number: '123', ...} components = {} for (var i = 0; i < place.address_components.length; i++) { component = place.address_components[i] components[component.types[0]] = component.short_name if (component.types[0] === 'locality') { components['locality_long'] = component.long_name } } var streetVal = '' // people can select just a street or a place from autocomplete // this is to avoid filling the street field with any "undefined"s if (components['street_number'] && components['route']) { streetVal = components['street_number'] + ' ' + components['route'] } else if (components['route']) { streetVal = components['route'] } else if (components['premise']) { streetVal = components['premise'] } // check several components for "city" var cityVal = '' var cityComponents = ['locality', 'locality_long', 'neighborhood', 'administrative_area_level_3', 'sublocality_level_1'] for (var i = 0; i < cityComponents.length; i++) { if (components[cityComponents[i]] && place.formatted_address.search(components[cityComponents[i]]) > -1) { cityVal = components[cityComponents[i]] break } } // fill in the values $('#street_address').val(streetVal) $('#city').val(cityVal) $('#state').val(components['administrative_area_level_1']) $('#zip_5').val(components['postal_code']) // show the value of the street input again $('#street_address').removeClass('autocompleting') $('#street_address').css('color', '#323a45') // manually trigger field validation by reevaluating validity $('#street_address').valid() $('#city').valid() $('#state').valid() $('#zip_5').valid() $('#zip_5').valid() } var isSafari = (navigator.userAgent.indexOf('Safari') != -1) && (navigator.userAgent.indexOf('Chrome') == -1) && navigator.userAgent.indexOf('CriOS') == -1 var isChromeWindows = navigator.userAgent.indexOf('Chrome') > -1 && navigator.userAgent.indexOf('Windows') > -1 && navigator.userAgent.indexOf('Edg') == -1 var isChromeAndroid = navigator.userAgent.indexOf('Chrome') > -1 && navigator.userAgent.indexOf('Android') > -1 && navigator.userAgent.indexOf('SamsungBrowser') == -1 var isFirefox = navigator.userAgent.indexOf('Firefox') > -1 var isFirefox80OrHigher = false if (isFirefox) { var userAgentParts = navigator.userAgent.split('Firefox/') firefoxVersion = parseFloat(userAgentParts[1]) isFirefox80OrHigher = firefoxVersion >= 80 } // not from vote.org var hasPartner = $('#partner')[0].value != '999999' && !!$('#partner')[0].value // is embedded on a page: window.top !== window.self if (hasPartner && (window.top !== window.self) && (isSafari || isChromeWindows || isChromeAndroid || isFirefox80OrHigher)) { // open in a new tab $($('#get_started_form')[0]).attr('target', '_blank') // will be shown first page again in new tab (with params carried over) $($('#get_started_form')[0]).attr('action', 'resubmit_first_page') function removeFormAfterRedirect() { setTimeout(function() { var partner_id = $('#partner')[0].value var redirect_url = 'https://web.archive.org/web/20200930224606/https://register.vote.org/?partner=' + partner_id var new_html = '<p>Your form was opened in a new tab.</p>' new_html += '<p>If you were not redirected, <a href="' new_html += redirect_url new_html += '" target="_blank" rel="noopener">click here to continue your registration</a>' var container = $($('.form-container')[0]) container.html(new_html) }, 1000) } $('input[name="commit"]').click(removeFormAfterRedirect) } </script> <script> var validDate = { validDate: ['date_of_birth_year', 'date_of_birth_month', 'date_of_birth_day'] } // setup form validation rules var form = ValidatedForm.init('#get_started_form', { rules: { 'first_name': { noDigits: true, noEquations: true, }, 'last_name': { noDigits: true, noEquations: true, }, 'zip_5': { zipcodeUS: true, }, 'email': { simpleEmail: true, noEquations: true, }, 'street_address': { noEquations: true, po_box: true, }, 'unit_number': { noEquations: true, }, 'city': { noDigits: true, noEquations: true, }, 'phone_number': { phoneUS: true, }, 'state': { constrainSelect: true, }, 'date_of_birth_month': validDate, 'date_of_birth_day': validDate, 'date_of_birth_year': validDate, } }); </script> </div> <div class="usa-grid overseas"> <div class="usa-width-one-whole"> <span>Overseas and military voters should visit <a class="underline" href="https://web.archive.org/web/20200930224606/https://www.overseasvotefoundation.org/vote/VoterInformation.htm" target="_blank">Overseas Vote Foundation</a></span> </div> </div> <footer> <div class="usa-grid"> <div class="usa-width-one-whole"> <div class="usa-width-one-half add-this"> <a href="https://web.archive.org/web/20200930224606/https://www.vote.org/technology" target="_blank">+ Add this tool to your website</a> </div> <div class="usa-width-one-half links"> <ul class="links-list"> <li> <a href="https://web.archive.org/web/20200930224606/https://www.vote.org/terms" target="_blank">Terms</a></li> <li> <a href="https://web.archive.org/web/20200930224606/https://www.vote.org/privacy" target="_blank">Privacy</a></li> <li> <a href="https://web.archive.org/web/20200930224606/https://www.vote.org/contact" target="_blank">Contact</a></li> <li> <a href="https://web.archive.org/web/20200930224606/https://www.expeditedssl.com/simple-ssl-scanner/scan?target_domain=absentee.vote.org" target="_blank">Security</a></li> </ul> </div> </div> <div class="usa-width-one-whole powered-by"> <strong><a href="https://web.archive.org/web/20200930224606/https://www.vote.org/" target="_blank">Powered by Vote.org</a></strong> </div> </div>  </footer> </div>  </body> </html>