Section 1 of 1 in this document
Juror Full Name
First Name
*
Last Name
*
Full Address
Street Address
*
City
*
State
*
Zip
*
Phone Number
*
Legal Exemption
*
Choose One
Over 70 Years of Age
Currently has a child Under Age 15
Enrolled and Attending College
Employed by State in Legislative Branch
Student In Public School or Private School
Military Stationed Out of the Country
Primary Caregiver or an invalid person
Served as an juror within the last 24 months (must have been selected and served)
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First Name
Last Name
Email
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Type
I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.
disregard this