Yavapai County Elections - Poll Worker Application

Yavapai County Elections
1015 Fair St., RM 228
Prescott, AZ 86305
(928) 771-3248 x8
yavapaivotes.gov
elections@yavapaiaz.gov

Are you willing and able to work 15+ hours on Election Day? Election Day is a continuous 15+ hour day starting at 5:15 AM and ending after all work is complete. Poll workers cannot leave their Vote Center until the Elections Department releases you. Poll Workers will be required to attend Poll Worker In-Person Training, review online resource content, and attend the Pre-Election Meeting.*

YESNO

STOP!

Thank you for your interest in being a Poll Worker. Due to the requirements of a 15+ hour work day, we are unable to accept your application at this time.

Are you willing to support the Constitution of the United States and the Laws of the State of Arizona?*

YESNO

STOP!

All Poll Wokers are required to take the Oath of Office agreeing to support the Constitution of the United States and the Laws of the State of Arizona.

Thank you for your interest in being a Poll Worker. Due to these requirements, we are unable to accept your application at this time.

Are you registered to vote in Yavapai County?*

YESNO

STOP!

Thank you for your interest in being a Poll Worker. Due to the requirements of being a registered voter in Yavapai County, we are unable to accept your application at this time.

Please register to vote at AZMVDNow.gov and then apply as a Poll Worker!

Your name as it appears on your voter registration record? *

First NameLast Name

Preferred name/ nickname?

What is your Political Party Affiliation?*

Residential Address - this address should match your voter registration record.*

Street Address

City*

State*

Zip Code*

Do you have a mailing address other than your residential address?*

YESNO

Mailing Address*

City*

State*

Zip Code*

Mobile Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Have you ever been a Poll Worker for another county?*

YESNO

If "YES", where, and in what capacity?*

What position(s) are you interested in holding? (Select all that apply)*

Inspector (In charge of Vote Center)Marshal (Keeps line moving)Ballot Judge (Distributes ballots)Ballot Box Judge (Monitors the Ballot Box)Electronic Poll Book Clerk (Voter check-in, checks I.D., etc.)Election Day Technician (Addresses issues with equipment)Ballot Marking Device Clerk (Assists voters with the BMD)Provisional Clerk (Assists voters who are voting a provisional ballot)Alternate (On call)

For more information on the above job duites, click on the link below:

https://www.yavapaivotes.gov/Elections/Poll-Workers/Poll-Worker-Job-Summaries

Are you able to perform the essential functions of the selected position(s) listed above without accommodations?*

YESNO

If "No," what accommodations do you need?*

How far are you willing to travel to your assignment on Election Day?*

5 Miles or less5-10 Miles10-20 Miles20+ Miles

Have you ever led a team of people?*

YESNO

If YES, share an example.*

Have you ever resolved a conflict between people?*

YESNO

If YES, share an example.*

Can you stay cool and calm under stressful situations?*

YESNO

If YES, share an example.*

I maintain situational awareness of my surroundings:*

What is situational awareness?SometimesMost of the timeAll of the time

What do you use a computer for most often? Check all that apply.*

I do not use a computerWork - creating documents, data entry, etc.Personal - Internet shopping, music, watching videos, and social mediaPlaying gamesEmail

How would you rate your computer skills. Enter a number between 1 (Worst) and 10 (Best) for the questions below. These answers will help us determine which Poll Worker position is best suited for you.*

	Enter a rating number between 1 (worst) and 10 (best)
1. How would do you rate your computer skills?
2. How would you rate your ability to change a printer cartridge?
3. How would you rate your ability to clear a printer paper jam?
4. How would you rate your ability to upload and download attachments to/from an email?
5. How would you rate your ability to scan a QR Code or scan a barcode?
6. Rate your confidence when using touchscreen devices?
7. Rate how interested you are in the newest available technology?
8. Rate how intuitive you are with newly purchased technology?
9. Rate your ability to work with tech support to troubleshoot technical issues?
10. How would you rate your ability to help others solve technical issues?

Tech Score

Poll Worker Attestation: I acknowledge that if hired as a Poll Worker in Yavapai County, I will help conduct the election with political neutrality and will NOT engage in any political discussions at in-person training, the pre-election meeting, or on Election Day. It is my responsibility to uphold election laws and protect the security of the election. I also declare that the information I have provided in this application is a true and accurate reflection of my skills, knowledge, and abilities.*

I Agree

Applicant Signature:*

Today's Date: *

Date