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Name
Work Phone ( ) -
?Home Phone ( ) -
RESIDENTIAL ADDRESS
Street
City
Zip
MAILING ADDRESS (If different than residential)
E-Mail Address
WHAT WOULD YOU PREFER TO SERVE AS? (Click on the position to view a description)
Clerk
Inspector
Coordinator
A-Team
Collection Center Worker
Election Night Tally Center
I am available to serve on:
June 8, 2010 Nobember 2, 2010
DO YOU SPEAK A LANGUAGE IN ADDITION TO ENGLISH?
Spanish ???? Vietnamese ???? Korean ???? Mandarin ???? Taiwanese ???? Cantonese Other
ARE YOU A REGISTERED VOTER IN ORANGE COUNTY? yes ?????no
If not, and you live in Orange County, click here
NAME OF EMPLOYER:
Comments:
