Request an Absentee Ballot for the upcoming Saturday, June 25, 2011 Cherokee Nation Election no later than Friday, May 13, 2011. Complete and mail to the address at the top of the form.

1. ABSENTEE BALLOT REQUEST
ATTENTION: CHEROKEE NATION ELECTION COMMISSION, PO BOX 1188,
TAHLEQUAH, OK 74465-1188
I am requesting an Absentee Ballot.
Name (Type or Print): _______________________________________________________________________
Address: ___________________________________________________________________________________
City, State, Zip: _____________________________________________________________________________
NEW ADDRESS: YES NO (Please Circle)
Phone Number: (______)_____________________________________(For our verification)
Date of Birth: ___________________________ (Blue Card No.) CO__________________________________
Signature: _______________________________________________________________Date: ______________
Cherokee Nation Election Information 1-800 353-2895
Absentee Ballot Request must be in office: Feb. 7, 2011 until May 13, 2011
(Cut along line)
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ABSENTEE BALLOT REQUEST
ATTENTION: CHEROKEE NATION ELECTION COMMISSION, PO BOX 1188,
TAHLEQUAH, OK 74465-1188
I am requesting an Absentee Ballot.
Name (Type or Print): _______________________________________________________________________
Address: ___________________________________________________________________________________
City, State, Zip: _____________________________________________________________________________
NEW ADDRESS: YES NO (Please Circle)
Phone Number: (______)_____________________________________(For our verification)
Date of Birth: ___________________________ (Blue Card No.) CO___________________________________
Signature: _______________________________________________________________Date: ______________
Cherokee Nation Election Information 1-800 353-2895
Absentee Ballot Request must be in office: Feb. 7, 2011 until May 13, 2011