Eureka Township Election Judge Application Form
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Email *
Name *
First and last name
Street Address *
Phone number *
What is your age? *
I can read, write and speak English. *
I am eligible to vote in Minnesota. *
What do you consider your political party affiliation to be? *
What Elections to work? (Select all that you are interested in) *
Required
Which shifts are you available to work?   *
Required
Please read and acknowledge the following statements:

If selected to serve as an election judge, I will adhere to the following:

*I will report to work at the assigned time
*I will be professional, courteous, and respectful
*I will assist all voters, regardless of race, color, creed, religion, national origin, sex, sexual orientation, disability, or age
*I will read and study the Election Judge Training Manual and other training materials provided
*If a training session is added, I will attend or complete the assigned Election Judge Training
*I will adhere to federal, state, and local election laws and policies
*I will keep election equipment and supplies secure and will operate said equipment as instructed
*I will immediately report to the Head Judge any malfunction or possible tampering of voting equipment or suspicious behavior that may threaten the accuracy of the vote
*I will remain a-political and refrain from making personal opinion comments while serving as an election judge


Notice:

All election judges are required to submit an election judge application which asks you to provide information which includes private information under the Minnesota Government Data Practices Act (MGDPA). This information will be used to make work assignments and to contact you regarding election judge training and other matters. In addition, the Township provides your phone number to head judges who are asked to contact you prior to Election Day. You are not legally required to provide any of the requested information. However, if you do not, the Township of Eureka will be unable to process your application.

Answer Certification*

I hereby certify that all answers to the questions on this application are true, I have read and agree to the statements and notice above, and I understand the intended use of the private data provided.

*
I am interested in additional information to become a Head Judge.  
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A copy of your responses will be emailed to the address you provided.
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