DuPage County IL – Election Judge Application

*Party Affiliation:
*First Name:
*Last Name:
*Gender:	Male Female
*Email:
*Address:
*City:
*State:
*Zip:
*Date of Birth:
*Daytime Phone:
Home Phone:
Is your home phone unlisted? Yes No
Your Township/Precinct:
*Would you be willing to work outside your precinct? Yes No
*Would you be willing to pick up election supplies? Yes No
*Rate your experience level using computers High Moderate Beginner None
*Are you fluent in a language other than English? Yes No
If Yes - which language/s?
*Position Desired: Election Judge Registration Officer Healthcare Judge Early Voting Judge

Application to be a Judge