2. City Hall
   1616 Humboldt Ave.
   West St. Paul, MN 55118-3972
   Ph: 651-552-4102
   Fx: 651-552-4190
   TDD: 651-322-2323
   www.wspmn.gov
4. Name*
6. Address1*
8. Apt, Suite, Unit
10. City*
11. State*
12. Zip*
14. Ward
15. Precinct
17. Email Adress*
18. Phone Number*
20. Availability on March 5th, 2024: Presidential Nomination Primary Election*

    1. I am available to work a full day from 6 a.m. - Close
    2. I am available to work a half day from 6 a.m. - 2 p.m.
    3. I am available to work a half day from 2 p.m. - Close
    4. I am not available to work on March 5th, 2024
22. Availability on August 13th, 2024: Primary Election*

    1. I am available to work a full day from 6 a.m. - Close
    2. I am available to work a half day from 6 a.m. - 2 p.m.
    3. I am available to work a half day from 2 p.m. - Close
    4. I am not available to work on August 13th, 2024
24. Availability on November 5th, 2024: General Election*

    1. I am available to work a full day from 6 a.m. - Close
    2. I am available to work a half day from 6 a.m. - 2 p.m.
    3. I am available to work a half day from 2 p.m. - Close
    4. I am not available to work on November 5th, 2024
26. Type of Judge (select all that apply)

    1. I would like to be a first-time judge
    2. I would like to continue to work as a regular election judge
    3. I would like to continue to work as a head judge
    4. I am interested in becoming a head judge
    5. I would like to be a healthcare facility voter outreach judge
    6. I would like to be a trainee judge (for ages 16-17)
    7. I cannot work this year but would like to remain on your election judge list
    8. Please remove my name from your election judge list
28. Do you have a relative who is applying to be an election judge in West St. Paul?*

    1. Yes

    1. No
29. If "Yes", please list name(s)
31. Are you a relative of any candidate for any of the offices on the ballot?*

    1. Yes

    1. No
33. If yes, please explain
35. Do you have any health concerns or other limitations?
37. Political Party Affiliation*

    State law requires that no more than 1/2 of the election judges in a precinct can be members of the same major political party. Once assigned and working at the polling place, election judges must remain non-partisan.

    1. Democratic-Farmer-Labor Party
    2. Legal Marijuana Now Party
    3. No Party Affiliation
    4. Republican Party of Minnesota
39. 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 email 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. For example, your contact information is needed to provide information to you such as precinct assignment, training schedules, cancelation 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.
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41. 1. Receive an email copy of this form.
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