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Election Inspector Response Form

2. First Name*

3. Last Name*

5. Address1

7. Address2

9. City

10. State

11. Zip

13. Phone Number*

15. Email Address

17. Have you worked for us previously
    -- Select One --NoYes, I worked the March 10, 2020 ElectionYes, but I did not work the March 10, 2020 Election and may need to update my W-9

19. Election Availability

    What 2020 Elections are you available to work?

    1. August 4, 2020
    2. November 3, 2020
21. Absentee Counting Board

    1. I am interested in working in the Absentee Counting Board processing Absentee Ballots at City Hall.

23. Computer Literacy*
    -- Select One --0 - I do not know how to use a computer1 - I can do basic things on a computer2 - I have some computer skills (social media and email)3 - I know how to use a computer (opening and saving documents using a flash drive)4 - I am skilled with my home computer and/or use a computer regularly at work5 - I am very skilled with computers (family and friends use me as tech support)5 +

25. Questions, Comments, Insights from previous elections:

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field