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Application to Become a Poll Worker

If you are interested in serving as a poll worker, please complete the application below. Make sure to include at least one phone number. Note: You must meet all qualifications and declare your political affiliation to serve as an Election Judge..

If your services are needed, you will be contacted prior to the next election and provided a schedule of the required training classes.

Note: High school juniors and seniors interested in serving as poll workers should obtain an Application for Student Poll Worker from their guidance counselor.

 

Name:
 
Address:
 
City:
 
Zip Code:
 
Email:
Home Phone:
Daytime Phone:
Date of Birth:
 
I am interested in serving as an: PLEASE CHECK ONE BELOW



Party Affiliation: PLEASE CHECK ONE BELOW. THIS IS REQUIRED FOR ELECTION JUDGES ONLY


 
If necessary, would you be willing to work outside your precinct?


 
I also certify I have read and understand the Qualifications of a Poll Worker and meet these requirements.