Election Worker Application

Election Worker Application

Term: January 1, 2026-December 31, 2027
Name*

First NameLast Name
Address (Must Reside in Racine County, Wisconsin)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
ELECTION INSPECTOR QUALIFICATIONS

IMPORTANT: Please review Election Inspectors Qualification Requirements before completing this application. The links below will open in a new tab:

Election Inspector Qualification Requirements

High School Poll Workers Qualification Requirements
Please indicate that you have read the Election Inspector Qualification Requirements

Yes, I understand the qualification requirements and I am qualified to serve as an Election Inspector.Yes, but I have a question.
Check all that apply to confirm you are an eligible elector or a qualified High School Student:

I am a U.S. citizen;I am at least 18 years of age, or;I am a High School student age 16-17 who meets poll worker qualifications;I have established residence for at least 28 days in my Racine County election district;I am not currently serving a sentence, including probation, parole, or extended supervision, for a felony conviction;I have not been ruled incompetent to vote by a court.
Have you previously worked as an Election Inspector?

NoYes. Please indicate where.
Do you work?

Full timePart timeNot otherwise employed
If employed, will you be able to get off work to serve as an Election Inspector?

YesNo
Are you available for Spring, Summer, and Fall Elections

YesNo
Please indicate the shift(s) you would be available to work.

AM Shift (6:30 am to 1:30 pm)PM Shift (1:15 pm to 8:30 pm)Full Day (6:30 am to 8:30 pm)
Please share why you would like to serve as an Election Inspector and/or let us know if you have any questions.
Please do not exceed 200 words.
Should be Empty: