Form Center

2. Submit this form to be added to Pittsfield Township's Permanent Absent Voter List. Once added to the Permanent Absent Voter List, you will receive an application for an Absent Voter Ballot in the mail approximately 60 days prior to each election. A signed application, returned to the Pittsfield Township Clerk's Office, is required prior to each election in order for a ballot to be sent.

4. First Name*
5. Last Name*
7. Address*
8. Apt #
10. City*
11. State*
12. Zip*
14. Year of Birth*
15. Phone Number
16. Email
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field