Pollworker App

Today's Date *

Name *

First

Last

Address *

City *

State *

Zip Code *

Email *

Contact Number *

Are you a registered voter in Missouri? *

• Yes
• No

Do you forsee any problems working from 5:30am – 8:00pm? *

• Yes
• No

Pollworker Qualificaton *

• I am a citizen of the United States
• I am at least 18 years of age
• I am a registered voter of Warren County, Missouri
• I have reliable transportation
• I am capable of working from 5:30am until 8:00pm
• I can read, write, speak, and understand the English language

I would prefer to work at: *

• I am willing to work at any precinct
• Concord Hill -- (St. Ignatius School)
• Dutzow – (Marthasville Fire Station)
• North Elkhorn – (Warrenton Lions Club)
• South Elkhorn/Macedonia (St. John’s Lutheran Church)
• Gore/Case – (Gore-Case Community Club)
• Hickory Grove South – (Wright City Lions Club)
• Hickory Grove North – (Wright City Lions Club)
• Holstein/Smith Creek – (Immanuel United Church of Christ)
• Hopewell – (American Legion Hall)
• Lake Sherwood – (Lake Sherwood Community Building)
• Lakeview – (Clubhouse Facility at Lake View Mobile Home Park)
• Marthasville East/Southwest – (Marthasville City Hall)
• Pendleton – (Warrenton Fire Station in Pendleton)
• Truesdale – (Truesdale City Hall)
• Walnut Grove – (Oak Grove Baptist Church)
• Warrenton Ward 1 – (Warrenton Baptist Church)
• Warrenton Ward 2 – (Friedens United Church)
• Warrenton Ward 3 – (College Methodist Church)
• Weeks – (Central Grove Methodist Church)

Party Preference *

• Republican
• Democrat
• Other party
• No party affilliation

By initialing and submitting this form, I do affirm that the above information is true and correct to the best of my knowledge *

Name

Submit