POLLING PLACE NAME
*
PRIMARY CONTACT'S NAME:
*
The name of the person responsible for coordinating your polling place.
First Name
Last Name
PRIMARY CONTACT'S PHONE NUMBER:
*
The phone number of the person responsible for coordinating your polling place.
(###)
###
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DELIVERY CONTACT'S NAME:
If someone other than the primary contact will be on-site to receive the delivery
First Name
Last Name
DELIVERY CONTACT'S PHONE NUMBER:
The phone number of the person who will be at the polling place when equipment is delivered.
(###)
###
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SETUP CONTACT'S NAME:
If someone other than the primary contact or delivery contact will be on-site for the equipment setup.
First Name
Last Name
SETUP CONTACT'S PHONE NUMBER:
The phone number of the person who will be at the polling place when equipment is setup.
(###)
###
####
EMERGENCY CONTACT:
*
The name of the person who can be reached at any hour in case of an emergency. Please provide someone other than the primary contact. I will always attempt to call the primary contact prior to the emergency contact.
First Name
Last Name
EMERGENCY CONTACT'S PHONE NUMBER:
*
(###)
###
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WILL YOU PROVIDE A KEY FOR 5:00 AM POLLING PLACE ENTRY ON ELECTION DAY?
*
IF NO, 5 AM DOOR OPENER
The person who is responsible for being on-site at the polling place at 5:00 AM on Election Day to open the doors. It is imperative that this person is not late.
First Name
Last Name
5:00 AM DOOR OPENER'S PHONE NUMBER:
(###)
###
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IF YES, KEY CONTACT
The name of the person our Technical Election Judge (Tech Judge) will contact to obtain a key to the polling place prior to Election Day
First Name
Last Name
KEY CONTACT'S PHONE NUMBER:
(###)
###
####
I HAVE INFORMED THE 5:00 AM DOOR OPENER OR KEY CONTACT THAT THEY ARE RESPONSIBLE FOR SECURING ELECTION DAY ENTRY INTO THE BUILDING
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Please inform the 5 AM Door Opener of their responsibilities and that it is imperative they are not late election morning.
If applicable, please inform the key contact that the Technical Election Judge (Tech Judge) will arrange a key pickup date prior to Election Day. Procedures and return of the key should also be covered at this time.
DELIVERY AND SETUP — Thursday October 31, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
DELIVERY AND SETUP — Friday November 1, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
DELIVERY AND SETUP — Sunday November 3, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
DELIVERY AND SETUP — Monday November 4, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
COMMENTS, CONCERNS, INSTRUCTIONS:
DELIVER — Thursday October 31, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
DELIVER — Friday November 1, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
DELIVER — Sunday November 3, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
DELIVER — Monday November 4, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
COMMENTS, CONCERNS, INSTRUCTIONS:
SETUP — Thursday October 31, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
SETUP — Friday November 1, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
SETUP — Sunday November 3, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
SETUP — Monday November 4, 2024
Please choose multiple days and times to give us flexibility when delivering and setting up equipment.
COMMENTS, CONCERNS, OR INSTRUCTIONS:
I have reviewed all information provided
*
