This form does not meet the requirements of common sense, much less the law. The General Assembly has mandated the requirements for the application and expects those requirement to be kept, or else the requirements would be changed.

But the other part of this has not been address, the VA Costitution, Article II, Section 2:

Applications to register shall require the applicant to provide the following information on a standard form: full name; date of birth; residence address; social security number, if any; whether the applicant is presently a United States citizen; and such additional information as may be required by law. All applications to register shall be completed by or at the direction of the applicant and signed by the applicant, unless physically disabled. No fee shall be charged to the applicant incident to an application to register.