EmailMe Form - Election Judge Application

I am a U.S. Citizen? *

YES

I WILL attend and pass the training class for Election Judges? (Usually 3 hours) *

YES

I AM a registered voter... *

YES

NO

Date of Birth *

MM / DD / YYYY

If you were born after 03/20/1994, please do not complete this form. You must use the Student Judge Application Form.

Name *

Address *

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

Home Phone

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

Cell Phone

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

Work Phone

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

Email *

Are you willing to work in a precinct other than the one in which you live?

YES

NO

Checking "NO" will not automatically disqualify you, however if your precinct of residence is full, we may not be able to appoint you.

I am fluent in the following languages: *

English

Spanish

Chinese

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

YES

May we add you to the ROOT email list for periodic updates? *

YES

NO

May we add you to Commissioner Liz Gorman's email list for periodic updates? *

YES

NO