The Elector List

First Name *

Last Name *

Email *

Mobile Phone *

Business Email

Business Phone

Residential Address *

Residential Apartment/Suite

Residential City *

Residential State *

Residential Zip Code *

Residential County *

State Voter Registration ID *

Birthdate *

Which best describes your Role? *
Citizen/Volunteer
County/State/Federal Worker

Local Group Affiliations

State Group Affiliations

National Group Affiliations

County Role:
Director
Voter Registration Maintenance Manager
Voter Registration Maintenance Staff
Other (please specify)

State Role:
Director
Voter Registration Maintenance Manager
Voter Registration Maintenance Staff
Other (please specify)

Other Role:
Elected Official
Candidate for Elected Office
Member of Media, Press (specify Organization)
Volunteer Election Worker
Other (please specify)

State and/or Counties you like to have access to *

State/County:

All Counties

OR

REFERRED BY

Name *

Email *

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Terms of Use Eligibility and Attestation

To obtain access, an applicant must be at least eighteen (18) years of age, provide and verify their legal name and a means of contact.

The applicant must further attest that the applicant:

has not been convicted of, or found civilly liable for, any election-related offense, including voter fraud, voter intimidation, or unlawful interference with an election;
has not been convicted of identity theft, or of fraud involving the misappropriation of another person’s personal information;
has not been convicted of unauthorized access to a computer or computer network, including any offense under the Georgia Computer Systems Protection Act or the federal Computer Fraud and Abuse Act;
has not been convicted of perjury, falsification of records, or making a false statement to a government agency;
is not subject to any court order restricting the applicant’s participation in election-related activity; and
has not previously had access to ELLY revoked for cause, and is not acting for or at the direction of a person whose access has been revoked.

A false attestation is cause for immediate revocation.

I attest to the Term of Use and am eligible to apply