Poll Worker - Online Application

  YOU MUST BE A REGISTERED VOTER IN THE STATE OF CALIFORNIA OR LAWFUL PERMANENT RESIDENT

*Indicates a required field
*Last Name:
*First Name:
Address:
  *House Number *Street Name Street Type Apt #
   
  *City Zip  
       
Email:
*Date of Birth: / / (mm/dd/yyyy)
*Home Phone:
Cell Phone:
Work Phone: Ext:
Permanent Resident Card Number:
   
I have served as an Election Worker in Alameda County. Yes      No 
I have my own transportation. Yes      No 
I will ONLY serve in a precinct in my City. Yes      No 
I am willing to serve anywhere in Alameda County. Yes      No 
I am fluent (speak, read, write) in English. Yes      No 
 
I am fluent (speak, read, write) in:
Cantonese
Mandarin
Spanish
Tagalog
Vietnamese
Japanese
Korean
Hindi
Khmer
Punjabi
       
 
Other
*Yes    I understand that I am required to attend a 3-hour mandatory training class prior to each election.
 
I have my own car (Required for Inspectors). Yes      No 
I am able to lift 35 lbs (Required for Inspectors & Judges). Yes      No 
 
I am interested in serving as an Inspector (manager of precinct). Yes      No 
I am interested in serving as a Judge (assistant manager). Yes      No 
I am interested in serving as a Clerk (assistant). Yes      No 
 
I am interested in serving at the Return Center (Election Night 8 PM to approx. 11 PM) Yes      No 
 
How did you hear about becoming an Election Worker?