Poll Worker Interest Form

If you would like to serve as an Officer of Election, please complete this interest form below. The Election Official coordinator will contact you concerning orientation and be able to answer any questions you may have.

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First Name

Last Name

Mailing Address

Day Time Phone

Enter a valid phone number. Example: 123-456-7890

E-Mail Address

Enter a valid email address. Example: name@company.com

Areas interested in working

Western Branch

Deep Creek

Indian River

South Norfolk

Great Bridge

Hickory

Greenbrier

All the above - Any location

Please enter the characters you see in the picture:

(Note: If you cannot read the numbers in the above
image, click the refresh button to generate a new one.)

If you have any questions, please contact ebwilliams@cityofchesapeake.net or call 757-277-9797.