Contact information

Question Title

* 1. Name:

Question Title

* 2. Mailing Address

Question Title

* 3. Best Contact Phone:

Party Affiliation

Question Title

* 5. Party Affiliation

Party Affiliation: State law requires that at least two judges must represent different major political parties. No more than one-half of the election judges in a precinct can be members of the same major political party. All election judges must declare a major political affiliation. If an election judge does not affiliate with a major political party, they must provide a statement confirming their “un-affiliation” status to the city clerk. Election judges that are not affiliated with a major party cannot perform tasks requiring party affiliation. Once assigned to a polling location and working at the polling place, election judges must remain non-partisan.
Experience and qualifications

Question Title

* 6. Are you 18 years of age or older and a United States Citizen

Question Title

* 7. Do you read, write and speak English

Question Title

* 8. Are you eligible to vote in Minnesota?

Question Title

* 9. Are you a candidate for or do you currently hold public or political party office?

Question Title

* 10. Are you a relative of any candidate for any of the offices on the ballot?

Question Title

* 11. Do you have a relative who is applying to be an Election Judge with the City of Bemidji?

Availability

Question Title

* 12. I am available to work the following elections

Question Title

* 13. I can work the following shift

Question Title

* 14. I am interested in working as

Other Information

Question Title

* 15. Check all that apply:

Wages and Time off From Work
  • You must complete an election judge training course (at least two hours).
  • Elections judges can choose to volunteer or be paid.
  • An individual who is selected as an election judge may be absent from their place of work for the purpose of serving as an election judge without penalty if they notify their Employer in writing at least 20 days prior to each election. (M.S. 204B.195).
Election Judge Responsibilities
To ensure fair and honest election results, if selected to serve as an election judge, I will adhere to the following:
  • I will arrive at my assigned polling place at the assigned time and remain until my assigned time or excused by the Head Judge.
  • I agree to be courteous, respectful and to assist all voters regardless of national origin, physical challenge or efficiency in the English language.
  • I agree to read and study the Polling Place Training Manual and any additional information. I will attend the Election Judge Training so that I am prepared to fulfill my assigned responsibilities to conduct the election according to federal, state and local election laws and policies.
  • I understand that we are responsible for the security of election equipment and supplies and I will handle and monitor all such equipment and supplies exactly as instructed.
  • I will refrain from making personal and political opinion comments while serving as an election judge.

Question Title

* 16. I have read and understand the eligibility requirements and duties and I hereby certify that I will adhere to those requirements. Please consider me as an applicant for election judge.

Question Title

* 17. Date

Date
Tennessen Warning: Under the Minnesota Government Data Practices Act (Minn. Stat §13.43), your name, address, telephone number, social security number, date of birth, party affiliation and e-mail are private data. You may choose not to provide some or all of this private data, but it may limit your ability to participate as an election judge. Your contact information is needed to provide information to you such as precinct assignment, training schedules, cancellation information, etc. By completing this information, you are consenting to allow information to be shared with payroll staff and election staff in order to administer this activity. This consent expires upon completion of this activity.

T