Voter Declaration Form

STATE OF LOUISIANA
VOTER REGISTRATION AGENCIES
DECLARATION FORM

Fields marked with * are required.








If you are not registered to vote where you live now, would you like to apply to register to vote here today?*

Applying to register or declining to register to vote will not affect the amount of assistance that you will be provided by this agency. Voter eligibility requirements are found on the voter registration application form.

Note: If you do register to vote, the location where your application was submitted will remain confidential. If you decline to register to vote, this fact will remain confidential. Applying to register or declining to register to vote will be used only for voter registration purposes.

If you would like help in filling out the voter registration application form, we will help you. The decision whether to seek or accept help is yours. You may fill out the application in private.*

For assistance in completing the voter registration application form outside our office, contact Student Services at (337) 421-6947 or ods@sowela.edu.

If completed outside our office, this declaration form and your completed voter registration application form (if you filled one out) should be returned to SOWELA, 3850 Sen. J Bennett Johnston Ave., Magnolia Building- Student Success Center, Lake Charles, LA 70615.

Enter first and last name





COMPLAINTS

If you believe that someone has interfered with your right to register or to decline to register to vote, your right to privacy in deciding whether to register or in applying to register to vote, or your right to choose your own political party or other political preference, you may file a complaint with the Louisiana Secretary of State, Commissioner of Elections, P.O. Box 94125, Baton Rouge, LA 70804-9125 or by calling (225)922-0900 or 1-800-883-2805.