Guardianship election for minors

Your Name
Name of person completing the questionnaire
Long Term Guardian
A long-term guardian is the person who will make decisions regarding a minor child’s support, care, education, health and welfare.
Who do you wish to appoint as the first long-term guardian?
If you are choosing a married couple, you may include both names in this field.
Relationship to you
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email

Do you wish to identify a second alternate long-term guardian?
- Yes
- No
It is helpful, but not necessary, to identify additional alternate long term guardians.
Who do you wish to appoint as your second alternate long-term guardian?
Relationship to you
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email

Limitation of Powers
Do you wish to place any limitations on the powers of the long-term guardian to act on behalf of your minor children?
- No
- Yes
Please describe.

Short Term Guardian
A short-term or temporary guardian is the first person to be contacted in the event of an emergency. In the event of your incapacity or death, the short term guardian is responsible to take immediate (but temporary) custody of your children until either you or the long term guardian can take physical custody of the children.
Who do you wish to appoint as your first short-term guardian?
Relationship to you
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email

Do you wish to identify a second alternate short-term guardian?
- Yes
- No
It is helpful, but not necessary, to identify additional alternate short term guardians.
Who do you wish to appoint as your second alternate short-term guardian?
Relationship to you
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email

Limitation of Powers
Do you wish to place any limitations on the powers of the short-term guardian to act on behalf of your minor children?
- No
- Yes
Please describe

Long Term Guardian