Form Center

2. Legal First Name
3. Legal Last Name
5. Preferred Name
7. Address
9. City
10. State
11. Zip Code
13. Email Address
14. Best Way to Contact

    1. Phone
    2. Email
16. Phone Number
20. Position Interested In (Select All That Apply)

    1. Election Day Poll Worker
    2. Early Voting Poll Worker
    3. Early Voting Ballot Board

    Election Day Workers can do split shifts (6 hours in the AM or PM). Ballot Board members meet 3 times over the course of a month. 

21. Party Preference

    1. Republican
    2. Democrat
    3. Independent
    4. Other
    5. No Preference
22. Election Preference

    1. Only non-partisan elections
    2. No Preference
    3. Other

    If there are certain elections you would prefer to work, or not work, please let us know here. 

24. If selected Other, please explain here.
26. Length of Duty Preference

    1. Half Day
    2. Full Day
    3. No Preference
27. Position Title Preference

    1. Judge
    2. Clerk
    3. No Preference

    Judges are compensated at $12/hour

    Clerks are compensated at $10/hour (Early Voting consists of only clerk positions)

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field