First Name

Address   

City           

E-Mail        

Phone         ( )

If yes, in what year did you last work?

I am interested in working at a Polling Place in the next: 6 mo 1 yr

I have my own transportation to get to and from a Polling Place: Yes No

I am fluent in English: Yes No

In addition to English, I am also fluent in:

Regarding technology, my comfort level can best be described as:
Fearless

Confident

Somewhat Cautious

Slightly Nervous

Uneasy

I am willing to attend an Elections Officer training class: Yes No

I am willing to accept the responsibility of following Election Code and all laws governing the conduct of elections: Yes No

I am able to lift 30 lbs:
Note: All lifting is to be done by two people.
Yes No

I understand that to work as an Election Officer I will be required to remain at the Polling Place all day on Election Day (except lunch breaks):
Yes No

I understand the Election Day begins at 6:15 am and ends approximately 30 min. after the polls are closed (8:00 p.m.): Yes No

I understand that I am required to assist the other members of my precinct board in Election Eve set-up at my assigned polling place: Yes No

I am interested in recruiting other individuals to work with me at the polls (Note: anyone recruited by you will also be required to complete an application): Yes No

My primary motivation for wanting to work as an Elections Officer is:

I have the following special skill(s) and/or professional experience, which I am interested in using to help the Registrar of Voters Office facilitate the electoral process:

I am not interested in working at a Polling Place, but would like to discuss other opportunities to help with elections. Please contact me by:

Phone US Mail E-mail Fax

Please Note: The Riverside County Registrar of Voters is anxious to appoint Pollworkers who reflect the demographic makeup of the County. We encourage interested members from demographic and/or language minorities to apply to work at the polls. We have a great demand for individuals with bilingual or multilingual skills. Each Polling Place is staffed by 4 Elections Officers and currently, the stipends paid are $125.00 for Inspectors (1) and $90.00 for Precinct Officers plus $20.00 for training. NOTE: YOU MUST work the Election in order to get the stipend for training. (3). Except for specially authorized progams for state and county employees, and high school students participating in the Student Pollworker Program, Election Officers must be registered voters within the County of Riverside. If you are interested and/or think you qualify for one of the above special programs please contact the Registrar of Voters: Election Officers and Polls Division at (951) 486-7341, 1 (877) 663-9906 toll-free, or TTY (951) 653-3718.