Transcription of DALLAS COUNTY ELECTIONS DEPARTMENT
1 1520 Round Table Dr DALLAS , Texas 75247 (469) 627-VOTE DALLAS COUNTY ELECTIONS DEPARTMENTPoll Worker Information Form Complete the information below for each worker from your party. Position: Presiding Co-Judge Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Select appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Select appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number.
2 __ __ __ - __ __ __ - __ __ __ __ Email Bilingual in Spanish Check here if workerwill attend training Select appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Bilingual in VietnameseBilingual in SpanishBilingual in VietnameseBilingual in SpanishBilingual in VietnameseBilingual in SpanishBilingual in Vietnamese 1520 Round Table Dr DALLAS , Texas 75247 (469) 627-VOTE DALLAS COUNTY ELECTIONS DEPARTMENTS elect appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Select appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Select appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code: Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Select appropriate position: clerk Standby Check here if this is a new worker Last Name: First Name: VUID #: Date of Birth: Residence Address (Street, Apt #): City: Zip Code.
3 Mailing Address, if different (Street, Apt #): City: Zip Code: Phone Number: __ __ __ - __ __ __ - __ __ __ __ Email Check here if workerwill attend training Bilingual in SpanishBilingual in VietnameseBilingual in SpanishBilingual in VietnameseBilingual in SpanishBilingual in Vietnamese Bilingual in SpanishBilingual in Vietnames
