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2. Temporary Elections Worker Interest Form
   Please fill out this online form for consideration as a temporary elections worker with the Jefferson County Clerk and Recorder.
4. First Name*
5. Last Name*
7. Primary Phone Number*
8. Secondary Phone Number
10. Your Email Address*
12. Residential Address*
14. Address Line 2
16. City
17. State
18. Zip Code
19. Country
21. Are you registered to vote?*

    1. Jefferson County
    2. Other County
    3. No
23. If you are currently registered in another county, please indicate which one.
25. Did you sign up at Caucus to be an Election Judge?

    1. Yes

    1. No
27. Political Party*

    1. Democrat
    2. Republican
    3. Unaffiliated
    4. Other
29. If you marked 'Other' in the field above, please let us know what party you are registered with.
31. How comfortable are you with computers?

    1. Very comfortable
    2. Comfortable
    3. Prefer no computer
33. Do you enjoy working with the public?

    1. Yes
    2. No; prefer behind the scenes position
35. Can you speak and translate another language?

    1. Yes

    1. No
37. If you marked 'Yes' in the field above, please let us know what language(s) you can speak and translate.
39. Have you worked with the Jefferson County Clerk and Recorder as an election (polling place) judge?

    1. Yes

    1. No
41. If you have worked with us before, please provide details.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field