Precinct Election Official Application

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919-545-8500 (Phone) Chatham County Board of Elections 919-542-6430 (Fax) PO Box 111 Pittsboro, NC 27312

www.Chathamnc.org/BOE 984 Thompson Street Suite D

Please Print

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Registered Party: __________________ Race: __________________ Gender: __________________

Residential Address: _________________________________________________________________________________

Street City, State, Zip

(If Different)

Email Address: ___________________________________________________________________ DOB: ______________

Home Phone #: _______________________________ Cell #: ___________________________________

Have you ever been a precinct election official? Yes ☐ No ☐

If you have, when______________________ what Position? _______________________________________

What Position would you like to serve as? Chief Judge ☐ Judge ☐ Election Assistant ☐

Fluent in: English ☐ Spanish ☐ List Others: ____________________________________________________________________________

Pleases describe in detail computer experience that you have, and customer service skills that qualify you to be a precinct election official:

__________________________________________________________________________________________________________________________________

OFFICE USE ONLY

Home Precinct: _____________________ Date Received: _________________

VRN#: ____________________________ Interview Date: _________________

Assessment Results: _________________ Interviewed By: _________________