Election System of the Virgin Islands
Sunny Isle Shopping Center, Christiansted, St. Croix, V.I. (340) 773-1021 
9200 Lockhart Garden, St. Thomas, V.I. (340) 774-3107 
 P.O. Box 1499  Kingshill St. Croix, U.S. Virgin Islands 00851 / P.O. Box 6038  St. Thomas, U.S. Virgin Islands 00804 
APPLICATION FOR ELECTION OFFICERS 
PERSONAL INFORMATION 
NAME: ____________________________________________________________ 
PHYSICAL ADDRESS: ________________________________________________ 
MAILING ADDRESS: __________________________________________________ 
TELEPHONE #: ______________________________________________________ 
DATE OF BIRTH: _________________ 
LAST FOUR OF SSN #: _______________ 
GOVERNMENT EMPLOYEE NUMBER: _________________ 
ERP VENDOR NUMBER:        ______________ 
ARE YOU A REGISTERED VOTER? 
_____ YES _____ NO 
PARTY AFFILIATION: (Circle One)    DEMOCRAT REPUBLICAN      ICM 
 NO PARTY 
POLLING PLACE IN WHICH YOU ARE REGISTERED; _________________________ 
WHAT LANGUAGE ARE YOU FLUENT IN: __________________________________ 
LIST PREVIOUS EXPERIENCE AS ELECTION OFFICERS OR YOUR PRESENT 
WORK HISTORY POSITION TITLES AND DUTIES: 
_____________________________________________________________________ 
_____________________________________________________________________ 
_____________________________________________________________________ 
I, certify that the information given above is correct and true to the best of my knowledge. 
__________________________ 
___________________________ 
Date 
Signature 
ELECTION SYSTEMS OF THE VIRGIN ISLANDS FORM 0020-REVISED 2025
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