Election Judge Application

First Name

 *

First Name

Last Name

 *

Last Name

Address

 *

Address

City

 *

City

State

 *

State

Zip

 *

Zip

Home Phone Number

 *

Home Phone Number

Cell Phone Number

Cell Phone Number

Email Address

Email Address

Desired shift:

 *

I can work a full 16-hour day (approximately 6 a.m.-10 p.m.)

I can work a half day from 6 a.m.-2 p.m. (must have flexibility in precinct assignment)

I can work a half day from 2 p.m.-close (must have flexibility in precinct assignment)

Are you interested in serving as a head-judge? (Head Judges require an additional hour of training and must be able to work a full day)

Yes

No

Political party designation:

 *

Democratic

Republican

Legal Marijuana Now

Not affiliated with a major party

I am available to work:

 *

March 5 Presidential Nominating Primary (PNP)

August 13 Primary Election

November 5 General Election

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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