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Juror Qualification Form

  1. Are you a citizen of the United States, as required by law to participate in jury service? *
  2. Are you a resident of Pierce County, as required by law to participate in jury service? *
  3. Are you at least 18 years old, as required by law to participate in jury service? *
  4. Are you able to read, speak, and understand the English language, as required by law to participate in jury service?*
  5. Are you unable to serve on a jury because of a physical or mental disability? *
  6. Are you solely responsible for the daily care of an individual with a permanent disability who lives with you? *
  7. Have you served on a jury within the last 12 months, or are you scheduled for jury service within the next 12 months?*
  8. Are you a “vulnerable individual” as defined by the categories named below? You may be asked to provide medical documentation of your condition.

    Check all that apply.

  9. Do you provide care for a “vulnerable individual” as defined in the previous question?*
  10. The court realizes that this is a very trying time in our nation’s history and that many jurors have had their lives disrupted as a result of the COVID-19 pandemic. One of the core foundations of our freedom and democracy are trials by jury.  

    In order to ensure trials by jury can continue safely in this trying time, the court has instituted several safety measures to protect you, the parties, and all court staff.  These safety measures include the following: requiring that anyone entering the courthouse wear a mask at all times while in the building; requiring that all individuals participating in jury service or trials maintain a distance of six feet from any other person at all times during the trial; and making masks, sanitary wipes, hand-sanitizer, and handwashing readily available to everyone.  

  11. Understanding this, if applicable, please check the appropriate box indicating if any of the following make it especially difficult for you to serve as a potential juror:
  12. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  13. By signing above, I swear or affirm under penalty of law that I have truthfully answered these questions

  14. Leave This Blank:

  15. This field is not part of the form submission.