Lehigh County Poll Worker Application

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* Name: Enter your name.
* Address: Enter your address.
* City: enter your city
* Zip Code: Enter zip code.
* Municipality: Input your Municipality
* Home Phone: Home or Primary Phone Number
Mobile Phone: Mobile or Secondary Phone
* E-mail: Enter a valid email address.
	I am fluent in Spanish
	I would like more information, please call me.
Comments: Additional Comments

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