EmailMe Form - Student Judge Application

If you are approved by the Republican Organization of Orland Township, we will contact the Cook County Clerk to email you an authorization form.

I Am a High School: *

Senior

Junior

I AM a U.S. Citizen *

YES

I AM a Cook County Resident. *

YES

My GPA is at least 3.0 on a 4.0 scale *

YES

I WILL attend and pass the Election Judge training Course. *

YES

All Information MUST be completed

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Date of Birth *

MM / DD / YYYY

Home Phone

### - ### - ####

Either home phone or cell phone MUST be entered or your application will be rejected

Cell Phone

### - ### - ####

Either home phone or cell phone MUST be entered or your application will be rejected

Email *

I am fluent in the following language(s)

English

Spanish

Chinese

I wish to be appointed as a REPUBLICAN Judge of Elections *

YES