- Please write in the County in the line provided at the top of the page just above the 9 lines for voter signatures. Only voters in that specified county may sign this petition. If someone from a different county signs the petition, it invalidates all the signatures on the page. Use a new petition for a different county.
- The circulator may sign their own petition form. [Only registered voters can sign petitions & only registered voters can circulate petitions.
- Use black or blue pen only.
- Fill out the petition from top to bottom legibly.
- Please ensure each voter fills out ALL the information correctly.
- A voter may only sign the Heartbeat petition one time. (There is another pro-life petition for a dismemberment bill. You may sign both.)
- The 1st block is the signature and the 2nd block is the printed name. Do not mix the two.
- After signing, print your FULL name (same as on their driver’s license), address, and today’s date.
- Write address where registered to vote. May NOT use a P.O. Box.
- Date is the actual date of the signature, NOT a birth date. Date format example: 10/25/2019.
- Fill out bottom right portion AFTER circulating, regardless of the number of signatures gathered.
- If a mistake is made, put a single line through any mistake and make the correction above.
- Don’t make copies of the petitions. If you would like more petitions, request them here: https://miheartbeat.org/request-petitions/.
In addition to having all the registered voters in your household sign the petition, please ask a friend, neighbor, or co-worker to add their signature as well. Only circulate petitions where allowed. Ask permission when necessary. If you are on public property, you must be at least 6 feet from an establishment’s door. Please consider a donation of any size.
Mail petitions to:
The Michigan Heartbeat Coalition
P.O. Box 136
Belmont, MI 49306