Poll Worker Application

1. Please note:
   Your application will be put on file and when new poll workers are needed, a Poll Manager may call you to see if you are available. <br><br>If selected, all poll workers are required to attend at least two hours of training classes prior to each election. Hours of work on election day are 6:00 a.m. until the end of the election (at least 8:00 p.m.) <br><br>If you have any questions, please call the Board of Elections at 706-613-3150

   Your application will be put on file and when new poll workers are needed, a Poll Manager may call you to see if you are available.
   
   If selected, all poll workers are required to attend at least two hours of training classes prior to each election. Hours of work on election day are 6:00 a.m. until the end of the election (at least 8:00 p.m.)
   
   If you have any questions, please call the Board of Elections at 706-613-3150

2. First Name*

3. Middle Name*

4. Last Name*

5. Suffix (i.e., Jr., Sr., III)

6. Complete Address*

7. Email Address

8. Phone Number(s)*

9. Have you ever worked at the polls before?*
   1. Yes
   2. No

10. Which election dates in 2012 are you available to work?*
    1. July 31, 2012
    2. August 21, 2012
    3. November 6, 2012
    4. December 4, 2012
11. Are you a citizen of the United States?*
    1. Yes
    2. No

12. Are you a resident of Athens-Clarke County?*
    1. Yes
    2. No

13. Can you read?*
    1. Yes
    2. No

14. Have you had a felony conviction in the last ten years?*
    1. Yes
    2. No

15. Do you hold public office?*
    1. Yes
    2. No

16. If you have a preferred poll site or area of town that you would like to be assigned to, please list here.

17. Are you willing to work from 6:00 a.m until 8:00 p.m.?*
    1. Yes
    2. No

18. Additional comments

19. Thank you for your interest in serving as a poll worker in Athens-Clarke County.

Leave This Blank:


20. 1. Receive email copy
21. Email address

22. Submit

* indicates a required field