Election Judge Sign-Up Form

Full Name:
Street Address:
City:
Zip Code:
Daytime Phone Number:	- -
Email Address: (optional)
	(Judges are required to declare their party in accordance with state law)

	Yes, I will work as an Election Judge for the November 4, 2008 election.
	Yes, I am willing to work in a different precinct, if needed.
	Yes, I am willing to pick up the election supplies before the election.
	Yes, I am willing to drive/be a passenger to the Brookens Center on election night to return supplies.
	Yes, I am willing to bring my cell phone for use in the precinct.
	My cell number is: - -
	Yes, I am willing to serve as a Nursing Home Judge prior to the election.
	No, I cannot work the November 4, 2008 election, but keep me in mind for future elections.
	No, I am resigning as an Election Judge for all future elections.
	If you know your voter number please enter it here:

	Enter Validation Words: