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Absentee Ballot Request Form

  1. Instructions

    This is the online absentee ballot request system for Westbrook's Municipal School Budget Validation Referendum held on June 13, 2023. To submit your absentee ballot request electronically, please provide the information below. 

    If you are not a registered voter in Westbrook or if you prefer to mail your request, please print a fillable PDF request form

    This online request system will be available through June 8, 2023. After that date, absentee ballots may requested in writing only if a special circumstance exists.

    Absentee ballots must be returned to Westbrook City Hall by 8:00pm on Tuesday, June 13, 2023.

  2. Online AB Request Icon
  3. Full Name of Registered Voter Requesting the Ballot
  4. Additional Voter Information
  5. (Example: mm/dd/yyyy)

  6. (Street number and street name of where you live in Westbrook)

  7. Contact Information
  8. (Example: 123-456-7890)

  9. (Please enter an accurate email address so that you may be contacted by the Westbrook City Clerk's Office in the event there is a problem with your request.)

  10. Ballot Delivery

    The absentee ballot will be mailed to the address you specify below. 

  11. Voter Certification

  12. Leave This Blank:

  13. This field is not part of the form submission.