Poll Worker Application

I would like to serve as(Required)

Judge of Elections

Inspector of Elections

Clerk

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone

Work Phone

Best Time To Call

If there are no vacancies in my precinct, I am willing to:(Required)

Work in a different precinct

Have my name placed on a list for future use for my precinct only.