Davidson County Election Commission Application printable pdf download

Davidson County Election Commission Application

DAVIDSON COUNTY ELECTION COMMISSION

700 2

AVENUE SOUTH, ROOM 153

NASHVILLE, TENNESSEE 37210

(615) 862-8800

NAME:_______________________________________________________________________

ADDRESS:____________________________________________________________________

CITY:________________________________________________________________________

TELEPHONE:__________________(HOME)_______________________________(WORK)

MAILING ADDRESS ( If different than street address) :

ARE YOU A REGISTERED VOTER IN DAVIDSON COUNTY? < < YES < < NO

SOCIAL SECURITY NUMBER________/______/________

POLITICAL AFFILATION: < < DEMOCRAT < < REPUBLICAN < < INDEPENDENT

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

YES

DO YOU HAVE COMPUTER EXPERIENCE?

YES

(Needed for Early Voting only)

WILL YOU WORK OUT OF YOUR PRECINCT?

YES

DO YOU HAVE RELIABLE TRANSPORTATION?

YES

Do not apply if you are presently employed by the Federal, State, or Local Government.

Tennessee State Law prohibits government employees from working at the polls on election

day. (TCA 2-1-112)

_______________________________________________

________________

Signature

Date

PLEASE ENCLOSE A XEROX COPY OF YOUR SOCIAL SECURITY CARD, METRO

PAYROLL DEPT. REQUIRES THIS BEFORE THEY WILL CUT A CHECK.

Davidson County Election Commission Application