Election Official Application

Preferred Name/Nickname

Only if different from legal name.

Do you have a different mailing address? *

Yes

No

Phone Number *

Example: 608-123-4567

Alternate Phone Number

Example: 608-123-4567

Email Address *

Are you a US Citizen *

Answering “No” or “Prefer not to answer” means you may only be assigned the position of Greeter.

Yes

No

Prefer not to answer

Have you ever been convicted of a felony? *

Answering “Yes” or “Prefer not to answer” means you may only be assigned the position of Greeter.

Yes

No

Prefer not to answer

Are you a high school student? *

Yes

No

Which high school do you attend? Other (specify)

Do you need any special accommodations? Please specify.

If yes, we will contact you to arrange for suitable accommodation.

Are you fluent in a language other than English?

Spanish

Hmong

Other (Specify)

Are you fluent in a language other than English? Other (Specify)

City Clerk's Office