Miami-Dade County Elections Poll Worker Application
Please answer question Name before continuing.
Please answer question Date of Birth before continuing.
Your answer to question Date of Birth must be a valid date.
Please answer question Street Address before continuing.
Please answer question City before continuing.
Please answer question State before continuing.
Please answer question Zip Code before continuing.
Please answer question Home Phone Number before continuing.
Please answer question Work Phone Number before continuing.
Please answer question Cellular Phone Number before continuing.
Please answer question Email Address before continuing.
Your answer to question Email Address must be a valid email address.
Your answer is shorter than the minimum allowed length of 9 characters.
Date of Birth
Home Phone Number
Work Phone Number
Cellular Phone Number
Voter Registration Number
Please answer question 2 before continuing.
Please fill in the text box next to the selected choice in question 2.
Do you have any computer or technological experience?*
Yes (Please Specify)
Please answer question 3 before continuing.
Please fill in the text box next to the selected choice in question 3.
Do you speak any other languages fluently?*
Yes (Please Specify)
Please answer question 4 before continuing.
Do you have access to reliable transportation?*
Please answer question 5 before continuing.
Please fill in the text box next to the selected choice in question 5.
Are you a current Miami-Dade County employee?*
If yes, obtain your supervisor’s approval to serve as a Poll Worker before submitting this application.
Yes (Name the Department)
Please answer question 6 before continuing.
Would you accept an assignment to a precinct other than your own?*
Please answer question 13 before continuing.
Please fill in the text box next to the selected choice in question 13.
How did you hear about the Poll Worker opportunity?*
Elections Outreach Event
Current Poll Worker (Name)
County Employee (Name)
College or University (Please specify)
High School (Please specify)
Other Website (Please specify)
Print or Newspaper Advertisement
City/Municipality (Please specify)
Other (Please specify)
Please answer question 14 before continuing.
By checking this box, I am confirming that I can read, write and speak in English and that the answers above are accurate to the best of my knowledge and belief.
Accommodations for persons with disabilities
People who require assistance because of their disabilities in order to participate in the programs, activities or services of the Miami-Dade County Elections Department, may contact Humberto Villamil at 305-499-8417 or
. To request materials in accessible format, sign language interpreters, or other means of equally effective communication to participate in any program or meeting, please contact him five days in advance to initiate your request. TTY users may also call 711 (Florida Relay Service.)
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