Request edit access
Virginia Election Protection 2019
Help the Virginia Civic Engagement Table protect the vote in Virginia this November by signing up to be a nonpartisan poll worker. We will have morning, afternoon and evening shifts. You'll receive an email with more information after you sign up!
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email *
Your answer
Home Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Do you have preferences on a polling location? (Note: we will try our best to accommodate or give a nearby precinct) *
Your answer
Do you have a vehicle? *
Your answer
Are you fluent in any language other than English? *
Your answer
Which shift will you commit to: *
What is you T-shirt size? *
Which training will you attend? *
Are you volunteering or would you like a stipend? *
Submit
Never submit passwords through Google Forms.
This form was created inside of Virginia Civic Engagement Table. Report Abuse