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Request For Appointment Form

  1. I am a registered voter in:

  2. Are you willing to serve out of your precinct if needed?

  3. I prefer to represent the:

  4. Are you willing to represent either party if needed?

  5. Thank you for applying. The strength of a democracy depends on the involvement of its citizens. Your form will be reviewed at the next electoral board meeting, which is the first Wednesday of every month.

  6. Leave This Blank:

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