Precinct Official Application

10 Precinct Official Application Applicant Information Full Name Date of Birth Last First MI mm dd yyyy Physical Address Street City , State , Zip Mailing Address E - Mail Address @ - Cell Phone - Alternate Phone Are you interested in working one - stop Which site are you interested in working at Register Political Party Voter Registration Number Yes No I am a US Citizen Yes No I am over the age of 18 I will be able to attend 2 - hour training sessions on 2 different days before elections Yes No I am able to lift 30 lbs Yes No I am able to work from 6 00 am to at least 8 00 pm on Election Day Yes No Skills Qualifications Education 1 2 3 4 College Enter highest grade completed 1 - 12 GED Graduate School 1 2 3 4 Brief Work Experience History Brief Summary - Elections Experience Please Explain - Computer Experience Please Explain - Please rate your knowledge of the following applications or computer areas Please enter the appropriate number 1 being zero knowledge & 10 being you could teach the class Microsoft Word Microsoft Excel Microsoft PowerPoint Microsoft Access Microsoft Publisher Microsoft Outlook Outlook Express Microsoft Internet Explorer SEIMS Absentee Module Used To Process Voters Computer Networking or Wiring Windows 2000 XP The information contained on this application is accurate and correct to the best of my knowledge Signed Date Johnston County Board of Elections form PE2 Please Mail or Return to PO Box 1172 Smithfield , NC 27577Page