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ELECTION OFFICIAL APPLICATION
Please print this form out before completing and
mail to:
LEE COUNTY AUDITOR'S OFFICE
P.O. BOX 190
FORT MADISON, IOWA 52627-0190
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Name:__________________________
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WHICH ELECTIONS
WOULD YOU LIKE TO WORK?
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Address:________________________
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__ Primary
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__ General
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__ School
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__ Municipal
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__ Special
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__ All
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City,State,Zip:___________________
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WOULD YOU CONSIDER
ANY OF THE FOLLOWING?
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HOW MAY WE
REACH YOU?
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Serve as
Chairperson for your precinct?
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Daytime
Phone:___________________
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__ Yes
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__ No
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Evening
Phone:___________________
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Work
outside your precinct?
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HOW ARE YOU
REGISTERED?
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__ Yes
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__ No
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__ Republican
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__ Democrat
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Work at a
satellite voting station?
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__ No Party
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__ Yes
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__ No
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