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CITY OF LEWISTON ELECTION WORKER INFORMATION FORM Name: Mailing Address: Street Address: Daytime Telephone: Evening Telephone: Email Address: Political Party Which elections are you available to work in? (Please check below): May June November All Elections (every year) (every other year) (every year) Election Day Preference (Please check a shift if you have a preference): Shift A Shift (6:00am – 2:00pm) (2:00pm - 9:30pm) Which election position are you interested in? (Training is provided for all positions): _______Warden ______Ward Clerk ______Ballot Clerk (In charge of entire polling place) (Assistant Warden) (Check off names on list, distribute ballots, etc.) Polling Place Location Preference: _______Longley School Gymnasium Green Ladle (high school campus) _______Lewiston Memorial Armory Hall-processing absentee ballots _______Montello School Gymnasium (Please note that we cannot guarantee a particular location, but we will try to accommodate your request.) Please note: Per Maine State Election law, election workers cannot be an employee of a political party, a candidate for office, or a member of a candidate’s immediate family. In addition, a person cannot have a direct pecuniary interest in the result of a referendum question appearing on the ballot. Please return completed form to City Clerk’s Office, Lewiston City Hall, 27 Pine Street, Lewiston, ME 04240 If you have any questions, please call [PHONE REDACTED]