JURY QUESTIONNAIRE

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Name:___________________________________ ___________________Address: ________________________________________ ____________Email Address:________________________________ _______________ Home Phone:__________________Work Phone: __________________Cell Phone: ____________________Date of Birth: ____________________Age: ________To receive text notifications, list the cell phone carrier:Marital Status:_____________________________Age( s) of Children:_________________________Number of Children:__________________Spouse s Name:____________________________Spouse s Occ:________________________Spouse s Emp:_____________________________Occupat ion:_________________________Employer: ________________________________Level of Education: ________________________Are you a United States Citizen?

of this form and return it to the Jury Manager. When responding to your questionnaire, whether by paper or through the online questionnaire, please provide an email address and/or cell phone number and carrier information so that the Jury Manager can send updates and notifications regarding your jury service.

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