Become A Poll Worker First Name(Required)Last Name(Required)Home Address(Required)City(Required)State(Required)Zip Code(Required)Mailing Address(Required)Date of Birth(Required)Phone Number(Required)Can we text this number?(Required) Yes No Email Address(Required)Preferred communication method:(Required) Text Message Email Phone I am registered to vote in Apache County as:(Required) Democrat Republican Other What language(s) are you fluent in?(Required) English Navajo Application Type:(Required) I am signing up as a new poll worker for Apache County I have been a poll worker before and want to again this year Are you able to work 14-16 hours on Election Day?(Required) Yes No Do you have your own transportation?(Required) Yes No Are you an Apache County employee?(Required) Yes No Are you related to any other poll workers?(Required) Yes No Are you related to any elected officials and/or political candidates?(Required) Yes No Please list up to 3 locations you are willing to work in.(Required)Agreement ConditionsBy checking the box below, you agree to the following:1. The Apache County Elections Department can dismiss an individual for failure to attend training, misbehavior, poor customer service, neglect of duty, insubordination, etc.2. Applicants agree to remain an eligible voter and must inform the Election Department in writing if they change Party affiliation.3. Applicants must attend in-person training and work as assigned to receive payment for training. Applicants must also work all day on election day to receive payment.4. By submitting this application, you agree to read and understand the Poll Worker Training Manual for all upcoming elections and follow the correct procedures as outlined in the manual.5. Applicant affirms that if hired as a poll worker, they will perform the duties according to all laws and to the best of their ability.I hereby certify, to the best of my knowledge, the information provided is true and accurate, and I have read and understood the information provided above.I consent to receive texts and emails related to elections and election schedules, training schedules, reminders and other election related information.I agree to the above terms.(Required) Yes, I agree. Δ
