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Precinct Official Application
Party affiliation:
*
field type radio button
Party affiliation:
Democratic
Republican
Libertarian
Unaffiliated
First name:
*
field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Last name:
*
field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Address:
*
field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Date of birth:
*
field type date
Gender:
*
field type radio button
Gender:
Male
Female
Email address:
*
field type email
Cell phone number:
*
field type number
Home phone number:
field type number
Alternative phone number:
field type number
I am currently a registered voter in Cabarrus County:
*
field type radio button
I am currently a registered voter in Cabarrus County:
Yes
No
I will be able to attend training sessions before each election:
*
field type radio button
I will be able to attend training sessions before each election:
Yes
No
I have basic computer skills and would be able to use a computer if necessary:
*
field type radio button
I have basic computer skills and would be able to use a computer if necessary:
Yes
No
I am able to lift 30 pounds:
*
field type radio button
I am able to lift 30 pounds:
Yes
No
I have my own transportation to and from a polling place on election day:
*
field type radio button
I have my own transportation to and from a polling place on election day:
Yes
No
I would be available to assist other officials on the eve of the election:
*
field type radio button
I would be available to assist other officials on the eve of the election:
Yes
No
I am able to work from 6:00 AM until all votes are counted on Election Day:
*
field type radio button
I am able to work from 6:00 AM until all votes are counted on Election Day:
Yes
No
I am 18 years of age or older:
*
field type radio button
If not, see Student Election Brochure
I am 18 years of age or older:
Yes
No
Would you be willing to work outside of your home precinct on Election Day?
*
field type radio button
Would you be willing to work outside of your home precinct on Election Day?
Yes
No
If so, how many miles can you travel?
*
field type number
How did you hear about this position?
*
field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Date of submission:
*
field type date
Signature:
*
field type signature
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