Election Judge Application Form

IF YOU ARE INTERESTED IN SERVING AS AN ELECTION JUDGE FOR PHELPS COUNTY:

Come to our office and fill out the application form, or to save yourself some time, you may print this form, fill it out, and deliver it IN PERSON to:

Pam K Grow, Phelps County Clerk
Phelps County Courthouse
200 N. Main St. Suite 102, Rolla, MO 65401
Phone: (573) 458-6101

NAME:__________________________________________________________________

ADDRESS:_______________________________________________________________

PHONE NUMBER:_________________________________________________________

POLITICAL PARTY PREFERENCE:___________________________________________

POLLING PLACE PREFERENCE (if any):______________________________________