College Judge of Election Application

Notes: 

• You must have transportation to the Poll Location in order to be assigned to work
• You must have your social security number in order to be paid.
• Your check will be mailed to your home address 4 to 6 weeks after the Election.

 *= required fields

Political Party*
(Select) Democratic Republican

First Name*

Last Name*

Date of Birth*

Gender *

Home Address*

City/Village*

State*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code*

Phone*

If you are fluent in other languages please list them (optional)

College or University Information

Name of College or University attending*
  

College/University Address*


Box # (if applicable)
 

City/Village*

State*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code*

School Email Address*

Please provide your Campus Housing Address below (if applicable)

Please provide the name of the individual you will be commuting with below  (if applicable)