Name

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Nickname

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Address

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Phone

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Preferred main number

Type

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{ binding firstError.message }

Phone

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Alternate phone number

Type

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{ binding firstError.message }

I accept the appointment as an Officer of Elections and I agree to represent the:

Democratic Party

Republican Party

Independent

{ binding firstError.message }

This does not affiliate you with a party for voting purposes – it satisfies legal requirements to ensure that all parties are fairly represented to protect the interests of all voters. However, if you wish assignment as Chief or Assistant Chief, you must select Democratic Party or Republican Party.

	Yes	No
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{{ $context.parentContext.dataItem.get_label() }}	{ binding displayValue, mode=oneTime }
{ binding firstError.message }
{{ $context.parentContext.dataItem.get_label() }}	{ binding displayValue, mode=oneTime }
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{{ $context.parentContext.dataItem.get_label() }}	{ binding displayValue, mode=oneTime }
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{{ $context.parentContext.dataItem.get_label() }}	{ binding displayValue, mode=oneTime }
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{ binding firstError.message }

Signature

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