Student Election Registration Form

Election Date: April 29th, 30th, May 1st, 2020

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* 1. Office Sought

Student Member, New Haven Board of Education

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* 2. Candidate Name:

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* 3. Candidate Address:(Street Address, City, State, Zip)

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* 4. Candidate Phone:

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* 5. Candidate Email:

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* 6. Candidate School:

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* 7. Candidate Graduation Year:

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* 8. Candidate Student ID #

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* 9. Statement of Intent: By submitting this registration form, the undersigned consents to placing his or her name on petition forms as a candidate for the office specified, which is to be contested at the citywide student elections to be held on the date listed above.

You will receive confirmation of receipt from:
nhpsstudentvoice@new-haven.k12.ct.us

I certify that the information above is true and correct.
Name:

Date:

(OFFICE USE ONLY) Candidate Eligibility Verification

Name

Date

System Used circle one

(SchoolNet,PowerSchool)

Statement of Verification: I hereby certify that I compared the name of the candidate listed above with our student information system and have verified their?

·       Name

·       Public high school enrollment

·       Grade level

·       New Haven residency

Signature: ______________________________________________

Date: _________________________________