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2. 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.

3. 
5. Full Name of Registered Voter Requesting the Ballot
7. First Name*
9. Middle Name
11. Last Name*
13. Suffix
15. Additional Voter Information
17. Voter's Date of Birth*

    (Example: mm/dd/yyyy)

19. Westbrook Street Address of Voter*

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

21. Contact Information
23. Phone Number*

    (Example: 123-456-7890)

25. Email Address*

    (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.)

27. Ballot Delivery

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

29. Street/PO Box Line One*
31. Street/PO Box Line Two
33. City/Town*
35. US State/Territory*
37. Zip/Postal Code*
39. Voter Certification

    By submitting this electronic absentee ballot request, I certify, under penalty of law, that I am a Maine registered voter, I am requesting my own ballot, and I completed this request form. I acknowledge that the information on this request, except for my email address, is public information to be used only for election-related activities.

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field