Humboldt County Online

Poll Worker Application

INSTRUCTIONS

Being a Poll Worker is a rewarding experience and is a vital role in the exercise of democracy.  Without Poll Workers, we could not conduct elections!

The requirements for becoming a Poll Worker are simple:  you must be a Humboldt County voter unless you are a high school student (call us for details on the Student Poll Worker Program 707-445-7481).

COMPLETE THE FOLLOWING FIELDS: 

1.  NAME:  Enter your first name, middle name or initial, and last name as registered.

2 .  RESIDENCE ADDRESS:  Enter the Humboldt County  address at which you live (your residence).  The city and ZIP code must be included.  A business, mailing, secondary or post office box (P.O. Box) address is not a residence and is therefore not acceptable. 

3.  TELEPHONE (Optional):  Enter your daytime phone number including area code.

4.  DRIVER'S LICENSE NUMBER:  Enter your California Driver's License number.  This will help us confirm your registration. 

5.  MAILING ADDRESS:  If different than your residence address, enter a mailing address.  We can send you material via email (faster) or via USPS.

6.  EMAIL ADDRESS:  In case we need to contact you quickly, please give us your email address.

  

 

1. Name (First Middle Last):

2. Residence Street Address:

Residence City and ZIP:

3. Telephone:

4. Driver's License No.:

5. Mailing Street Address:

Mailing City, State, and ZIP:

6. Email address: