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Fayette County Poll Official Application

Personal Information:

Title

*First Name

Middle Name

*Last Name

*Street Address:

Appt / Suite:

*City:

*State:

*Zipcode

*Home Phone:

Cell Phone:

Work Phone:

*Email Address:

Application:

Are you a Fayette County Resident?	Yes No
Will you accept Temporary Work?	Yes No
Do you have a valid GA License and your own transportation?	Yes No
GA License Number:
Are you a Fayette County Employee?	Yes No
Have you ever worked as a poll worker in Fayette County?	Yes No
Have you ever worked as a poll worker in another County in Georgia?	Yes No
Are you familiar with personal computers?	Yes No
Are you familiar with Microsoft’s Windows Operating System?	Yes No
Brief description of past work history:

Are you willing to work at any precinct in Fayette County?	Yes No
Which location would you be most interested in working?

If necessary, would you serve as an Alternate (stand-by) poll worker?	Yes No
Do you speak any language(s) other than English fluently?	Yes No
If yes, please identify the languages(s):
Would you be interested in working as a poll worker during advanced voting?	Yes No
Would you be interested in working absentee by mail?	Yes No
Why do you think poll workers are important to conduct Elections?

Do you foresee any problems in working from 6:00AMto 8:30PM (i.e. 14.5 hours) on Election Day(s)?	Yes No
Do you foresee any problems in attending the mandatory poll worker training classes?	Yes No
I am at least 16 years of age.	Yes No
Are you 21 years of age or older?	Yes No
I am a United States Citizen.	Yes No
I do not hold a public office; I am not a candidate for public office or related to a candidate for public office whose name will appear on the ballot.	Yes No
This application will be maintained in files for two years from the date of the application. Applicants will be considered when work is available by the Board of Fayette County Elections and Voter Registration.

Copyright © 2015 Fayette County Administration. All rights reserved.

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Fayette County Administration

140 Stonewall Avenue West
Suite 100
Fayetteville, Georgia 30214

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