Juror Information Form - May 2-2022
Monroe County Circuit Court
Jurors Name
*
First Name
Middle Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
ST
ZIP
Mailing Address (if different from Home)
Street Address or PO Box
Street Address Line 2
City
ST
ZIP
Cell Phone
Please enter a valid phone number.
Home Phone
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
If no phone, a contact number
Please enter a valid phone number.
Date of Birth
*
-
Month
-
Day
Year
Date
Race
Please Select
White
Black
American Indian
Asian
Hispanic
Pacific Islander
Sex
*
Please Select
Male
Female
Employer
Occupation (previous occupation if retired)
Years at Employer
Round up to years
Retired
*
No
Yes
Marital Status
Married
Single
Divorced
Separated
Widowed
Number of Children
Spouse's Name
First Name
Last Name
Spouse Retired
*
No
Yes
Spouse's Employer
Spouse's Occupation (previous occupation if retired)
Spouse's Years at Employer
Round up to years
If Spouse Retired - How Long
Round up to years
How long Have you lived in Monroe County
*
Round Up to Years
Level of Education Completed
Please Select
Elementary
Junior High
High School
Some College
College Graduate
Graduate School
Have you ever served on a Jury
*
Please Select
Yes
No
If yes, what type of Jury
Please Select
Criminal
Civil
Grand
Have you ever been accused, complainant or witness in a criminal case
Yes
No
Have you ever been accused, complainant or witness in a civil case
Yes
No
If you live outside the city limits of Aberdeen, how many miles (one way) are your from the courthouse
Round up to the nearest mile
By submitting this form you certify that all the information provide is true and correct.
Submit
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