New Election Judge Application Form
Apply to be an Election Judge in Rock Island County.
Election judges are the life-blood of the American democracy!
After you apply and your submission is accepted, you will be contacted by the County Clerk's Office with more details for scheduling an Election Judge training session.
Illinois law requires that Election Judges be assigned to represent either the Democratic or Republican Party. We recognize that there are many individuals who don’t align themselves with either party, however in order to fairly represent both parties in the Vote Centers, Election Judges must indicate the party they identify with the closest.
* Required
Email address
*
Your email
I am a United States Citizen:
*
Choose
Yes
No
I will attend & pass training before I work an Election:
*
Choose
Yes
No
I am a:
*
Choose
Rock Island County registered voter.
High School student.
First name:
*
Your answer
Last name:
*
Your answer
Middle initial:
Your answer
Suffix:
Choose
Jr.
Sr.
II
III
IV
Birth date:
*
MM
/
DD
/
YYYY
Home phone (with area code):
Your answer
Work phone (with area code):
Your answer
Cell phone (with area code):
Your answer
Home address (house number and street name):
*
Your answer
Mailing address if different from home address:
Your answer
City, State, and ZIP Code:
*
Your answer
Party (you most closely identify with):
*
Democratic Party
Republican Party
Terms & conditions: This website is made available to users by the Rock Island County Clerk's Office for the sole purpose of facilitating their participation as Election Judges. By using this website, users certify that the information provided is accurate and complete. Please make sure your information is up-to-date.
*
I accept the Terms & Conditions.
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