Skip to main content
Toggle navigation
Rutherford County Election Commission
Main Menu
HOME
VOTER INFORMATION ▾
Voter Registration Application
Am I Registered to Vote?
2024 Election Schedule
How to Register to Vote
Where to Vote
Early Voting
Absentee Voting
Overseas & Military Absentee (UOCAVA)
MTSU Student Voting
Forms
ID Requirements
Lost Voter Registration Card
Restoration of Voting Rights
CANDIDATE INFORMATION ▾
2024 Candidate Schedule
Qualifying as a Candidate
Financial Disclosure
Tennessee Registry of Election Finance
Rules for Displaying Campaign Signs
Voter Registration Data Information
Early Voting Data Request
Forms
ELECTION WORKER ▾
Information & FAQ's
Poll Worker Application (Electronic)
Poll Worker Application (Downloadable PDF)
Election Worker Training Videos
MAPS ▾
County District Map
Vote Center Locations
Find Nearest Voting Center
State House Districts
State Senate Districts
Road Board
School Board
CONTACT US
PAST RESULTS
Election - Poll Worker Application
NAME
First
Middle
Last
Voter #
SSN
Date of Birth:
Address:
Address
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
ZIP/Postal Code
Cell Phone
Do you use text messaging?
Yes
No
Home Phone
Email
Political Party Affiliation
Democrat
Republican
Independent
Party Balance
The state requires party balance at all polling sites. We staff an equal number of Democratic and Republican workers at each site.
Do you have a valid TN Driver's License & reliable means of transportation to and from the polls?
Yes
No
Do you have computer experience?
Yes
No
Employment Status
Full Time
Part Time
Military
Unemployed
Retired
Where are you currently employed (if applicable)?
Do you have problems SITTING for long periods of time?
Yes
No
Do you have problems STANDING for long periods of time?
Yes
No
Are you currently employed by a Federal, State, or Local Government Agency?
Yes
No
TN Code Ann. 2-1-112
Tennessee law prohibits government employees from serving as election officials EXCEPT any employee of a county or city school system or a Tennessee State Employee who does not work for an elected official.
Have you ever been convicted of a felony?
Yes
No
Have you ever worked as an Election Official?
Yes
No
Previous Election Worker Experience (if applicable)
Are you available to work the following dates for the 2024 Election Cycle?
Questions
Yes
No
Tuesday, March 5, 2024
Yes
No
Thursday, August 1, 2024
Yes
No
Tuesday, November 5, 2024
Yes
No
Positions Needed: (please indicate your preference)
Registrar
?
Machine Operator
?
Other…
Enter other…
I hereby certify that the information provided above is true and accurate
Reset
Sign above
Date of Application
Submit