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Election Inspector Application

  1. Contact / Personal Information

  2. Registered In*
  3. If you are registered in a township, please provide the township name and precinct.

  4. To be eligible for an appointment you must check on.

  5. Party Affiliation*
  6. Have you ever been convicted of a felony or election crime?
  7. When completing your Educational Background, please include the highest grade completed or degrees held.

  8. When adding your Employment Background, please include your current or last place of employment and the type of work performed.

  9. If you have past experience as an Election Inspector, please include the name of the jurisdiction in which you served.

  10. Certification - By submitting this form, I certify that I am not a member or a known advocate* of a political party other than the party identified above. I further state that the foregoing statements are true to the best of my knowledge and belief.

  11. Leave This Blank:

  12. This field is not part of the form submission.