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Poll Worker Application Form

Please fill out the following form to apply to become a Wayne County Poll Worker.

* Denotes required field.

Are you a registered voter in Wayne County?:* Yes     No

Name:*

E-Mail:

Address:*

City:*

Zip Code:*

Home Phone:*

Cell Phone:

Date of Birth:*

Political Party:* Democrat      Republican

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Wayne County
Board of Elections
200 Vanover St. Suite 1
Wooster, OH 44691-4849
P: 330-287-5480
F: 330-287-5686
E-Mail Us