Election Worker Application

Date of Birth (mm/dd/yy)
Florida Voter Registration Number
Your Email
Home Phone Number (xxx-xxx-xxxx)
Cell Phone Number (xxx-xxx-xxxx)
Street Address
Zip Code
Mailing Address (if different)
I'm interested in serving as:

What is your current/last occupation?
Please check all that apply:

Other than English, please specify other languages you know.
"By clicking on the Send button below, I certify that the foregoing answers are true, that I have read and understand the foregoing, that I have no physical disabilities that would hinder my performance at the polls, that I am now a registered voter in Nassau County and I can read and write the English language as required by Florida law"
Please note: After completing this application, you will become part of our pool of prospective election workers. Your name will remain active until you request that it be removed. 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.
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.

Designed by the Nassau County Supervisor of Elections Office  |  All rights reserved copyright 2013