Poll Worker Application

Name

Address

City

Daytime Phone

Cell Phone

Answer all of the questions below.

Are you able to lift 45 lbs?

Do you use a computer on a regular basis?

Check which elections you are able to work. *Priority is given to those who work on both elections

Primary Election
General Election

Are you willing to attend the mandatory training?

Are you physically able to sit or stand for long periods of time?

Are you available to work up to 14 hours on Election Day?

Have you previously served as a poll worker?

How did you learn about becoming a poll worker?

Type the code from the image