Election Worker Application
Note: Please provide your name as it shows on your voter registration.
* Last Name
* First Name
M.I.
Preferred Name
Pronoun
he/him
she/her
they/them
* Address
* City
* State
* Zip Code
Mailing Address (if different from above)
City
State
Zip Code
* Email
Note: We will be communicating with you via e-mail, so please provide an e-mail address.
* Primary Phone
Alternate Phone
Work Phone
* Date of Birth
* Are you a registered voter of Harris County?
Yes
No
* Are you a high school student?
Yes
No
* Have you ever worked as an election worker in Harris County?
Yes
No
If you answered "Yes", where did you work?
* Would you be willing to travel to work at a Vote Center?
Yes
No
How far would you be willing to travel?
What is your political affiliation?
Democratic
Republican
Non-Partisan
Other
Are you able to speak one of these languages? Check all that apply.
Spanish
Vietnamese
Mandarin
Cantonese
* How did you hear about the Election Worker Recruitment?
Mail
Newspaper
Television
Radio
Internet/Social Media
Family/Friend
Presiding Judge
Other
Any additional information you wish to include:
Please make sure that you complete all fields that are preceded by an asterisk (*).
Submit
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