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Election Judge Application

Home Cape Girardeau County Clerk Election Judge Application

"*" indicates required fields

Section 1: Applicant Information

First Name*

Last Name*

Day Phone*

Cell Phone

Email Address*

Home Address*

City*

State*

Zip Code*

Do you have a separate mailing address?*

Yes

No

Mailing Address*

Mailing City*

Mailing State*

Mailing Zip Code*

Communication preference for Election Assignments*

Email

Postal Mail

Section 2: Questionnaire

Are you a registered voter in Missouri?*

Yes

No

County of Registration*

Do you have reliable transportation?*

Yes

No

Do you forsee any problems working a 14 1/2 hour day?*

Yes

No

Do you have any computer experience?*

Yes

No

Please rate your computer skills*

Beginner

Intermediate

Advanced

Are you willing to work at a different polling place other than your own?*

Yes

No

How far are you willing to travel to your assignment on Election Day?*

5 miles or less

5-10 miles

10-20 miles

20+ miles

Section 3: Political Party

Election authorities are required by Missouri statutes to have an equal number of Democratic and Republican election judges at the polls (115.081, 115.087, RSMo).

Please select one Political Party*

I am interested in being a Democratic Election Judge

I am interested in being a Republican Election Judge

Section 4: Acknowledgement and Signature

I certify that my answers are true and complete to the best of my knowledge.

Today's Date*

Signature

Phone

This field is for validation purposes and should be left unchanged.

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Your Name*

Email Address*

Name

This field is for validation purposes and should be left unchanged.

Cape Girardeau County

#1 Barton Square, Jackson, MO 63755

+1 573 243 1052

Mon - Fri: 8:00 a.m. - 4:30 p.m.

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