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Poll Worker Application Request

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Please correct the field(s) marked in red below:

Contact Information
 *
Contact Information
Preferred method of contact:
 *
Preferred method of contact:
Are you registered to vote?
 *
Are you registered to vote?
If no, are you 16 or 17?
If no, are you 16 or 17?
  1. To receive a copy of your submission, please fill out your email address below and submit.