June 2020
2020 ABSENTEE BALLOT BOARD
ELECTION JUDGE APPLICATION
Anoka County Elections and Voter Registration2100 3
rd
Ave, Suite 130, Anoka MN, 55303
Phone: (763) 324-1
763-324-1300 Email: elections@co.anoka.mn.us
Fax: (763) 324-1160
CONTACT INFORMATION:
Name: _________________________________ Email: _________________________________________________
Ad
dress: ______________________________________________ City & Zip: _________________________________
H
ome Phone: ____________________ Cell Phone: ____________________ Work Phone: ____________________
Preferred Correspondence Method: ☐ Email ☐ Postal Service
EMERGENCY CONTACT:
Name: _________________________________ Relationship: _________________ Phone: ____________________
ELIGIBILITY:
Indicate the following by checking the corresponding Yes or No box:
Are you currently employed by Anoka County?...................................................................
Are you eligible to vote in the State of Minnesota?.............................................................
Are you able to read, write and speak English?...................................................................
Are you a candidate in the election?....................................................................................
Are you related to a candidate or another election judge?.................................................
If yes, write person’s name & relationship below:
MAJOR PARTY AFFILIATION:
☐ Democratic-Farmer-Labor
☐ Republican
☐ Grassroots-Legalize Cannabis
VOLUNTARY SERVICE:
☐ I am volunteering to serve without pay (optional)
Continue to second page - MUST complete availability and certify
