Absentee Ballot Request Form

To request an absentee ballot, please complete the form below. Absentee ballots must be returned to our Friendship office by Friday, May 5 at noon.

Date*
MM slash DD slash YYYY
Name*
First Last
Street Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
ACEC Member Number:*
Authorization*
I wish to submit this form electronically and hereby authorize the Cooperative to verify the information in this form.
- Accept
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Phone
This field is for validation purposes and should be left unchanged.