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Election Board Worker Application

  1. Please fill out and submit ONLY if interested in being a worker.
  2. Basic Information
  3. Address & City
  4. Can you accept text messages?*
  5. Would it be ok if we sent information to you via text and email?
  6. Would you like to:*
  7. Are you registered to vote?*

    All election workers must be registered voters in Riley County.

  8. What is your party affiliation?*
  9. History and Experience
  10. 1. Have you ever worked at an election before?*
  11. 2. Do you have computer experience?*
  12. 3. Are you willing to work at any polling location in Riley County?*
  13. 4. Do you need any accommodations to assist in fulfilling your duties?*
  14. 5. Are you able to stand for long periods of time?*
  15. 6. Have you ever been convicted of a misdameanor or felony?*
  16. Name, Address & Phone

  17. Please list a name(s) and telephone number(s) of someone that we may contact in an emergency.
  18. Please Read:
    “I swear or affirm that I am a citizen of the United States and a Kansas resident, that if convicted of a felony, I have had my civil rights restored. I have told the truth on this worksheet, and the information provided is complete and correct to the best of my knowledge. I understand that any incomplete, incorrect or false information furnished by me may void this application.”
  19. Leave This Blank:

  20. This field is not part of the form submission.