Statewide Election Judges Application

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County/City of Residence *

Name *

Please provide your full name.

Residential Address (street, city, and zip) *

Please provide your voter registration address.

Mailing Address (street or P.O. Box, city, and zip)

Only if different from your residential address

Daytime Phone *

Evening Phone

Cell Phone

Email Address *

Party Affiliation *

Democratic

Republican

Libertarian

Unaffiliated

Other:

Date of Birth

YYYY

Have you served as an election judge in Maryland before?
*

Yes

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This form was created inside State of Maryland.