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1. Your current county of residence (Required.)

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2. Are you currently employed by Community Action of Southeast Iowa? (Required.)

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3. Vote for one person to be the Lee County Representative of the Low-Income on the Board of Directors for Community Action of Southeast Iowa (Required.)

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4. I have (or will) only vote ONE time in this election (Required.)

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5. Are you currently below 200% of the Federal Poverty Level?
2021 200% Federal Poverty Guidelines
(Required.)

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6. Have you been below 200% of the Federal Poverty Level in the last 10 years?
2021 200% Federal Poverty Guidelines
(Required.)

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7. I certify my above answers are true and correct (Required.)

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