Free appnomsb.p65 - Wyoming

School Board Trustee Application for Election
State of Wyoming County of ) ) ss. W.S. 22-22-202 )

I, the undersigned, swear or affirm that I was born on _______________, _____(year), and that I have been a resident of the State of Wyoming since _____________________, and that I am a registered voter of the _____________________school district (and resident of trustee residence area or subdistrict__________________, if any), residing at __________________________________________________________________, and I do hereby request that my name, _________________________________________________, be printed on the ballot of the election to be held on the 2nd day of November 2010, as a candidate for the office of School Board Trustee for a term of _____ years. I hereby declare that if I am elected, I will qualify for the office. DATED this _________ day of ____________________, 2010. _________________________________ Signature ___________________________________
Print or type your name exactly as you wish it to appear on the ballot. (W.S. 22-6-111 states that professional titles and degrees shall not appear on the ballot.)

_________________________________ Residence Address _________________________________ Mailing Address (if different) _________________________________ City or Town, Zip Code _________________________________ Telephone Number _________________________________ E-mail Address _________________________________ Website Address

Gender: Male

Female

_______________________________________
In order to meet federal requirements for audio ballots and to accommodate individuals with disabilities, please print your name phonetically on the line above. (i.e., Peggy Nighswonger would be Peg-gee Nice-wong-ger)

Filing Dates Filing Office Filing Fee

... ... ...

August 4 through August 23, 2010 County Clerk None This form can be accessed on the Secretary of State's WEBSITE at:

http://soswy.state.wy.us/Forms/FormsFiling.aspx

Qualifications for Office
* Are you holding an office which may conflict, or be incompatible, with the office for which you are filing? Or, is your employment incompatible with the office you are seeking? Qualified elector residing within the school district and in the trustee residence area, if the district is divided into residence areas. (W.S. 22-22-201(a))
For office use only: Candidate Packet _______

*

03/2009 appnomsb