Election Officer Request Form

To e-mail this form click the send button at the end of the form. 
You may print this form on your printer and mail the completed form 
to the address at the end of the form.

Last Name, Middle Initial
First Name, Suffix
Date of Birth dd/mm/yyyy
*Social Security Number *Confidential
Street Address
                   Street Address2
City
State
Zip Code
County
Work Phone
Home Phone
FAX

Complete this section if  you receive your mail at a location other than your residence address.
Mailing Address
City
Zip Code
E-Mail Address
You may receive communications from the Department of   Elections concerning upcoming events.

             
 

DEPARTMENT OF ELECTIONS FOR SUSSEX COUNTY
119 N. RACE STREET
PO BOX 457
GEORGETOWN DE 19947

DEPARTMENT OF ELECTIONS FOR SUSSEX COUNTY