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This voter registration application was collected by the Honorable Rufus A. Lewis and is part of his collection at the Trenholm State Technical College Archives in Montgomery, Alabama. Lewis, a World War II veteran and longtime activist, set up citizenship schools for Montgomery's black population to help them register to vote. He also became a leader in his city's bus boycott in 1955-56.
Alabama changed the registration system four times in 1964-1965 in order to keep blacks from registering to vote. There were as many as 100 versions of the test in circulation at one time, making it impossible to study for it.
QUESTIONNAIRE
1. State your name, the date and place of your birth, and your present address
2. Are you single or married?
(a) If married, give name, resident and place of birth of your husband or wife, as the case may be:
3. Give the names of the places, respectively, where you have lived during the last five years; and the name or names by which you have been known during the last five years:
4. If you are self-employed, state the nature of your business:
A. If you have been employed, by another during the last five years, State the nature of your employment and the name or names of such employer or employers and his or their addresses:
5. If you claim that you are a bona fide resident of the State of Alabama, give the date on which you claim to have become such bona fide resident:
(a) When did you become a bona fide resident of _____ County:
(b) When did you become a bona fide resident of _____ Ward or Precinct:
6. If you intend to change your place of residence prior to the next general election, state the facts:
7. Have you previously applied for and been denied registration as a voter?
(a) If so, give the facts:
8. Has your name been previously stricken from the list of persons registered?
9. Are you now or have you ever been a dope addict or a habitual drunkard?
(A) If you are or have been a dope addict or habitual drunkard, explain as fully as you can:
10. Have you ever been legally declared insane?
(a) If so, give details:
11. Give a brief statement of the extent of your education and business experience:
12. Have you ever been charged with or convicted of a felony or crime or offense involving moral turpitude?
(a) If so, give the facts:
13. Have you ever served in the Armed Forces of the United States Government?
(a) If so, state when and for approximately how long:
14. Have you ever been expelled or dishonorable discharged from any school or college or from any branch of the Armed Forces of the United States, or of any other Country?
If so, state facts:
15. Will you support and defend the Constitution of the United States and the Constitution of the State of Alabama?
16. Are you now or have you ever been affiliated with any group or organization which advocates the overthrow of the United States Government or the government of any State of the United States by unlawful means?
(a) If so, state the facts:
17. Will you bear arms for your country when called upon it to do so?
If the answer is no, give reasons:
18. Do you believe in free elections and rule by the majority?
19. Will you give aid and comfort to the enemies of the United States Government or the Government of the State of Alabama?
20. Name some of the duties and obligations of citizenship:
(A) Do you regard those duties and obligations as having priority over the duties and obligations you owe to any other secular organization when they are in conflict?
21. Give the names and post office addresses of two persons who have present knowledge of your bona fide residence at the place as stated by you:
Insert Part III (5)
(The following questions shall be answered by the applicant without assistance.)
1. What is the chief executive of Alabama called? Governor
2. Are post offices operated by the state or federal government? Federal Government
3. What is the name of the president of the United States? Lyndon B. Johnson
4. To what national lawmaking body does each state send senators and representatives? Congress
Instructions "A"
The applicant will complete the remainder of this questionnaire before a Board member and at his instructions. The Board member shall have the applicant read any one or more of the following excerpts from the U. S. Constitution using a duplicate form of this Insert Part III. The Board member shall keep in his possession the application with its inserted Part III and shall mark thereon the words missed in reading by the applicant.
EXCERPTS FROM THE CONSTITUTION
1. "The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause supported by oath or affirmation, and particularly describing the place to be searched, and the person or things to be seized."
2. "Representatives shall be apportioned among the several states according to their respective numbers, counting the whole number of persons in each state, excluding Indians not taxed."
3. "Treason against the United States, shall consist only in levying war against them, or in adhering to their enemies, giving them aid and comfort."
4. "The senators and representatives before mentioned, and the members of the several legislatures, and all executive and judicial officers, both of the United States and of the several states, shall be bound by oath or affirmation, to support this constitution."
INSTRUCTIONS "B"
The Board member shall then have the applicant write several words, or more if necessary to make a judicial determination of his ability to write. The writing shall be placed below so that it becomes a part of the application. If the writing is illegible, the Board member shall write in parentheses beneath the writing the words the applicant was asked to write.
HAVE APPLICANT WRITE HERE, DICTATING WORDS FROM THE CONSTITUTION
Signature of Applicant _________________________________
Source: Hon. Rufus A. Lewis Collection, Archives, H. Council Trenholm State Technical College, Montgomery, Alabama. http://www.alabamamoments.state.al.us/sec59ps.html
page created on 8.23.06
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