Become a Poll Worker!
Email address *
Full Legal Name *
Date of Birth *
MM
/
DD
/
YYYY
Street Address *
City *
Zip Code *
Email *
Telephone *
Political Affiliation (Select one)
Clear selection
Have you ever been convicted of a felony (select one)? *
Have you ever worked as an election official (select one)? *
Education
If you are a current city or county employee, list the department and phone number
Select one
Clear selection
I understand I must meet these criteria (check all as acknowledgement)
Submit
Never submit passwords through Google Forms.
This form was created inside of Lucas County Board of Elections. Report Abuse