The Official Website of the City of Indianapolis and Marion County

Marion County Election Board Poll Worker Application

NOTE TO PRECINCT COMMITTEEPERSONS:This online application is not a substitute for using a board form. You can download board forms on our site, call our office at (317) 327-5100 or request them from your political party. Please return your board form to your political party headquarters.

NOTE TO HIGH SCHOOL STUDENTS:Instead of using this online application, please download the application on our forms download page . If you have any questions, you can call our office at (317) 327-5100 or your local political party headquarters.

I am a registered voter and a resident of Marion County and would like to be placed on a list of potential poll workers for the November 6, 2012 general election. (If you are not currently registered to vote, please click here to do so before applying for this position.)

* Denotes a required field

Name Prefix:*: Mr. Ms. Mrs. Miss First Name:* Middle:Last Name:* Suffix:Date of Birth:* (MM/DD/YY)Street:* City:* Zipcode:* Home Phone:* Daytime Phone:* Mobile Phone:Email Address:* Note: If we are unable to contact you by phone, you will be disqualified from the poll worker position.

Other Information

For which position are you applying?*

Inspector Judge Clerk Any What is your political party affiliation?*

Democrat Libertarian Republican Other Have you ever worked as a poll worker in Marion County?

Yes No Are you an employee of the City of Indianapolis or Marion County?*

Yes No If yes to previous question, in which department or agency do you work?*

If you are applying to be an Inspector, do you have access to reliable transportation to pick-up and return election materials?

Yes No Are you willing to work in a precinct away from your neighborhood?

Yes No Are you willing to use your personal mobile phone on Election Day?

Yes No Do you have text messaging capability on your mobile phone?

Yes No How did you hear about becoming a poll worker?

Facebook Twitter Election Board Web site Friend of Democracy yVote Other When would you prefer to attend training?

Monday - Friday Saturday Any Day What time of day would you prefer to attend training?

Morning Afternoon Evening Any Time By checking the box below, I certify that I am currently registered voter in Marion County, and my answers are correct to the best of my knowledge and belief:

I Agree: