RandolphCountyBoardofElections
PrecinctElectionOfficialApplication
LastName FirstName MI Nickname Iamapplyingforthe
positionof:
ChiefJudge/Judge
Assistant
OneStopWorker
Rover
ResidenceAddress
City,State,Zip
MailingAddress(ifdifferentthanResidenceAddr ess) DateofBirth
HomePhone WorkPhone CellPhone
Pleasechecktheappropriatebox:
IamcurrentlyaregisteredvoterinRandolphCounty.Yes No
Iwillbeabletoattendmandatorytrainingbeforeeachelection.Yes No
IhavemyowntransportationtoandfromapollingplaceonElectionDay. Yes No
Iam
abletoworkfrom6:00a.m.toapproximately9:00p.m.onElectionDay. Yes No
IamabletohelpsetupmypollingplaceonthedaybeforeEle ctionDay. Yes No
Inregardtotechnology(computers,printers,scanners,etc.),mycomfortlevelcanbestbedescribed
as:
Confident SomewhatCautious Uneasy
PoliticalPartyAffiliation
Democrat
Republican
Unaffiliated
Libertarian
E‐MailAddress
MAIL,FAXOREMAILTHISAPPLICATIONTO:
RandolphCountyBoardofElections
158WorthStreet
Asheboro,NC27203
Fax(336)318‐6903
elections@co.randolph.nc.us