Application to be an Election Judge

NOTE: Thanks to a great response in the past few weeks, if you submit an application below to become an Election Judge, you will be placed on a STANDBY LIST at this time. If there is a need for more judges, you will be contacted. We encourage you to complete the form if you would like to be placed on the standby list for the 2017 Consolidated Primary and Consolidated Elections.

I would like to become an Election Judge for the City of Bloomington Board of Election Commissioners. By submitting this application, I affirm that:

“***I am not subject to the registration requirement of the Sex Offender Registration Act (10 ILCS 5/13-4.)

***I understand that on Election Day I will be required to work from 5:15 a.m. until after the polls are closed and all is ready in my polling place to return results to the Election Commission office, and I may be asked to assist in returning results/equipment to the office, which I am willing to do. I am also willing to help set up the polls on the night before Election Day.

I realize I will represent a party in the polling place, and if voting in a partisan primary, I may ONLY vote this party ballot during my term as Election Judge.”

Name:
Address:
Birth Date:
Phone:
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Cell Phone:
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Daytime Phone, if different from above:
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E-mail:
Party, Democrat or Republican:
Signed, enter your initials:
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