ADMINISTRATION

BOARD OF ELECTIONS

Board of Elections Office
Historic Court House Complex
5903 Main Street
Mays Landing, NJ 08330-1701
609.645.5867
609.645.5875 FAX

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BOARD OF ELECTIONS - Challengers' Badges and Permits Application

The appointment of or application for challengers shall be filed with the County Board not later than the second Tuesday preceding any election. NJRS 19:7-3.

INSTRUCTIONS:

DO NOT USE YOUR BROWSER BACK BUTTON DURING THE APPLICATION PROCESS!

Please complete the following application in as much detail as possible. Please note that mandatory fields are indicated with *.

Click on the SUBMIT at the bottom of the page when you have completed the application. After you click on the SUBMIT button you will be taken to a page that will provide you with the opportunity to review your application and make any revisions necessary. Once you've completed this process your Challenger Application will be submitted to the Board of Elections electronically. You must print, sign and return application to the Board of Elections Office for it to be completed.

PRINT AND MAIL FORM: You may also print and mail the form if you prefer. Click here to go to the Print and Mail form now.

The following information will be used to complete the application:

NOTE: All Fields marked * are mandatory!

Municipality

Office:

Political Party (if applicable)

Election Type:

Election Date:

Candidate First Name:

Candidate's Last Name:

Candidate's Address:

Person Submitting Application:

Applicant First Name:

Applicant Last Name:

County Chair

Municipal Chair

Candidate

Duly Authorized Representative:

Phone Number:

Email Address:

Date:

11/21/2009

List the Names of the challengers below with the complete designation of the Election District of the Municipality to which they are assigned. If you need more space click the box for "Additional Challenger Spaces Needed" before you hit the submit key.

	Ward	District	Full Name of Voter (as recorded in Voter Record	Voter's Home Address	Municipality
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19
20

Additional Challenger Spaces Needed

	Atlantic County Government DEPARTMENT OF ADMINISTRATION Board of Elections