Student ​Poll Worker Application

Name:*
Address:
Home phone:
-
Cell Phone:
-
Work phone:
-
E-mail:
Place of Employment:
Voting Precinct #:
Voting Polling Location:
Emergency Contact:
Party Affiliation:

**Pursuant to A.C.A  7-4-107(a)(2), the Election Commission will appoint workers in accordance with party affiliation.**


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In order to be paid for working at the polls, new workers must submit a photocopy of your social security card and complete a W-4 Form.

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Qualifications of Election Officials Designated as Poll Workers(Arkansas Code Ann. § 7-4-109):

• Must be a qualified elector of this state
• Must be able to read and write the English language
• Must be a resident of the precinct in which he or she serves at the time of his or her appointment,
  unless the county board determinesunanimously that it is impossible to obtain qualified election officials
  from the precinct, in which case, the election official
  may be qualified county residents
• Must not have been found guilty or pled guilty or nolo contendere to the violation of any election law of this state
• Must not be paid employees of any political party
• Must not be paid employees of any person running for office
• Must not be a candidate for any office to be filled at an election while serving as an election official
• Must not be married to or related within the second degree of consanguinity to any candidate running
  for office in the current election
  if objection to the service is made to the county board of election
  commissioners within ten calendar days after posting
  the list of election officials

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Student Poll Worker Questionnaire


Poll Workers are vital to the election process; we need workers that are patient, helpful, courteous and considerate.  If you possess these traits, you will enjoy working Pulaski County Elections!  Please answer the following questions for us:

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What college or university to you attend?:
Are you participating in this program in order to receive extra credit for a class? a.) If yes please indicate your professors name:
Would you consider being the Equipment Clerk that is specially trained on operation of the voting devices?:
How familiar would you say you are with election laws and voting procedures?:
Would you be willing to work in a voting precinct other than your own?:
How far would you be willing to travel in Pulaski County to work at a polling site?:
Please tell us why you want to be a pollworker:

Thank you so much for your interest in being a

part of the election process!