Special Voter CoordinatorSpecial Voter Coordinator DetailsFirst NameLast NamePhone/MobileLocation DetailsZoneWardVDVoter DetailsFirst NameLast NameIDGender- Select -MaleFemalePhone/MobileVoter Address DetailsSpecial Voter Eligibility- Select -Elderly(60+)Person with DisabilityTemporarily Disabled/InjuredPregnantEssential Worker(Unavailable on Voting Day)Other(Specify)Type of Special Vote Required- Select -Home VisitVoting StationNot SureSubmit Form
