Candidate’s Florida Voter Registration Number (located on your voter information card):
(Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no
hyphen, check box . (See page 2 - Compound Last Names). No change can be made after the end of qualifying.
Although a write-in candidate’s name is not printed on the ballot, the name must be printed above for oath purposes.)
am a candidate for the nonpartisan office of ,
,
(Office) (District #)
,
; I am a qualified elector of County, Florida;
(Circuit #) (Group or Seat #)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I
have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office
I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes;
and I will support the Constitution of the United States and the Constitution of the State of Florida.
Section 876.05, Florida Statutes, oath (only applicable if elected and when term of office begins): I, a citizen of the State of
Florida and of the United States of America, and being employed by or an officer of the school board and a recipient of public
funds as such employee or officer, do hereby solemnly swear or affirm that I will support the Constitution of the United States
and of the State of Florida.
CANDIDATE OATH –
SCHOOL BOARD
NONPARTISAN OFFICE
Check box only if you are seeking to qualify as a
write-in candidate:
Write-in candidate
I,
Candidate Oath
(Sections 99.021(1)(a) and 105.031, Florida Statutes)
Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio
ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.]
X
( )
Signature of Candidate
Telephone Number Email Address
Address City State ZIP Code
STATE OF FLORIDA
Signature of Notary Public
COUNTY
OF
Print, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me by
physical or
online presence this day of , 20 .
Personally Known: or Produced Identification:
Type of Identification Produced:
