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2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Date of Birth

    Students must be at least 16 years of age in order to participate as a Student Election Clerk.

13. Best Way to Contact

    1. Phone
    2. Email
15. School Enrolled At

    1. China Spring ISD
    2. Clifton ISD
    3. Cranfills Gap ISD
    4. Hico ISD
    5. Iredell ISD
    6. Kopperl ISD

    1. Meridian ISD
    2. Morgan ISD
    3. Valley Mills ISD
    4. Walnut Springs ISD
    5. Home School
16. Interested in Working the Following Election

    Name of Election or Date will Suffice.

Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit Submit and Print

* indicates a required field