Election Officer Interest Form

Officer of Election Interest Form

  1. Please check yes or no for the following questions:
  2. Are you a registered voter in the state of Virginia?
  3. Are you willing to work during Early In-Person Voting?
  4. Are you comfortable working with election equipment such as tablets, scanners and tabulators?
  5. Are you willing to work at a precinct other than the one you are registered for?
  6. Are you able to lift up to 40 pounds, sit and/or stand for prolonged periods of time?
  7. Are you able to start working at 5:00 am and work for 14 hours or more on Election day?
  8. Please note: After completing this interest form, you will become a part of our pool of prospective election workers. Your name will remain active for 3 years. Not all election workers work every election. The number of election workers for each election is determined by the size of the election and the expected turnout. Election workers are chosen to work specific elections based on their availability, willingness to travel, and the number of workers needed.
  9. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  11. This field is not part of the form submission.