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Candidate Information Statement

First Name*
Middle Name
Last Name*
Residential Address*
City*
State*
Zip Code*
Mailing Address is the Same as Residential Address?*
Mailing Address*
City*
State*
Zip Code*
Phone No.*
Alternate Phone No.
Email Address*
How would you like your name to appear on the ballot?*
(i.e. Bob Smith, instead of Robert Paul Smith)
Name of Office / Title for which you are seeking Nomination Paper*
Trustee Area, Division or Zone
(If Applicable)
Ballot Designation*
(i.e., Farmer / Business Owner. Up to 3 words. No verbs.)
Candidate Handbook
Please Note: You must download and review the Candidate's Handbook before submitting this application.

Click here to open the Candidate's Handbook in a new window.
Candidate Acknowledgement*
I acknowledge that I have read and understand the above-mentioned information and have reviewed the Candidate Handbook. I also understand that providing false information on a Declaration of Candidacy is punishable by a fine not exceeding one thousand dollars ($1,000) or by imprisonment in the state prison for sixteen months or two or three years or by both such fine and imprisonment. Election Code §18203. (If you have any questions, you can contact us at 209-385-7541.)
1. Yes, I Agree

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