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2. I am applying for the position of (Check all that apply)*

   1. Chief Judge
   2. Judge

   1. Assistant
   2. One-Stop Official

   1. Election Day
   2. Rover

   1. MAT Team
4. Legal Last Name*
5. Legal First Name*
6. Middle Initial*
8. Nickname (name you may go by)
9. Date Of Birth*
   Date Of Birth
10. Gender*

    1. Male
    2. Female
12. Party Affiliation*

    1. Democrat
    2. Republican

    1. Libertarian
    2. Constitution

    1. Green
    2. Unaffiliated
14. Home Address*
16. City*
17. State*
18. Zip Code*
20. Mailing Address (if different)
22. City
23. State
24. Zip Code
26. Home Phone Number
27. Cell Phone Number
28. Can We Text You?

    1. Yes
    2. No
30. Email Address
31. Which method do you prefer?

    1. Mail
    2. Email
35. Section A.
    Please check the appropriate box for each item:
37. I will be able to attend a 3 hour training session:

    1. Day
    2. Evening
    3. Either
39. I have my own transportation to and from a polling place on Election Day:

    1. Yes
    2. No
41. I am willing to work outside of my precinct:

    1. Yes
    2. No
43. I am available to work from 6:00 a.m. to at least 8:00 p.m. on Election Day:

    1. Yes
    2. No
45. I am able to lift approximately 30 lbs:

    1. Yes
    2. No
47. I understand I will be required to assist in my precinct on the eve of the election: (approx. 2 hours)

    1. Yes
    2. No
49. I have basic computer skills and would be available to use a computer if necessary:

    1. Yes
    2. No
51. I am currently over the age of 18 (If not, please ask for Student Assistant Application):

    1. Yes
    2. No
55. Section B.
    (If applying for One-Stop position)
57. I am available to work all weekdays of the entire one stop period:

    1. Yes
    2. No
59. I am available to work Saturdays if needed:

    1. Yes
    2. No
61. I understand I am assigned to work one station the entire one stop period and attend additional training:

    1. Yes
    2. No
63. Which shift do you prefer to work during the one stop period?

    1. Morning
    2. Afternoon
    3. Either
67. Section C.
    (If applying for Election Day Rover position)
69. I understand that I am required to have a valid driver's license:

    1. Yes
    2. No
71. I have my own reliable transportation:

    1. Yes
    2. No
75. NOTICE TO APPLICANT-PLEASE READ BEFORE YOU AGREE BELOW:
    Persons appointed to these positions must be registered voters and residents of the county in which the precinct is located, of good repute, and able to read and write. Not more than one judge in each precinct shall belong to the same political party as the chief judge. No person shall be eligible who holds any elective office under the government of the United States or of the State of North Carolina or any political subdivision thereof. No person shall be eligible to serve as a precinct official who is a candidate for nomination or election. No person shall be eligible to serve as a precinct official who holds any office in a state, congressional district, county, or precinct political party or political organization, or who is a manager or treasurer for any candidate or political party, provided however that the position of delegate to a political party convention shall not be considered an office for the purpose of this subsection. The following categories of relatives are prohibited from serving as precinct officials of the same precinct: spouse, child, spouse of a child, sister or brother. No precinct official who is the wife, husband, mother, father, son, daughter, brother or sister of any candidate for nomination or election may serve as precinct official during any primary or election in which such candidate participates. The Board of Elections may remove you as a precinct election official for misbehavior or neglect of duty.
77. Click To Agree*

    1. I have read the above information
78. Date
    Date
Leave This Blank:


80. 1. Receive an email copy of this form.
81. Email address

    This field is not part of the form submission.

82. Submit

* indicates a required field