Fulton County Poll Worker Registration Application Question Title * 1. Please enter your contact information. Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number OK Question Title * 2. ETHNICITY OK Question Title * 3. GENDER OK Question Title * 4. ARE YOU A FULTON COUNTY RESIDENT? Yes No OK Question Title * 5. DO YOU HAVE A VALID GA LICENSE AND YOUR OWN TRANSPORTATION? Yes No OK Question Title * 6. ARE YOU A FULTON COUNTY EMPLOYEE? Yes No OK Question Title * 7. HAVE YOU EVER WORKED AS A POLL WORKER IN FULTON COUNTY? Yes No OK Question Title * 8. ARE YOU FAMILIAR WITH PERSONAL COMPUTERS (PCS)? Yes No OK Question Title * 9. ARE YOU FAMILIAR WITH MICROSOFT WINDOWS OPERATING SYSTEM? Yes No OK Question Title * 10. IF NECESSARY, WOULD YOU SERVE AS AN ALTERNATE (STAND-BY)? Yes No OK Question Title * 11. OTHER THAN ENGLISH, DO YOU FLUENTLY SPEAK ANY OTHER LANGUAGES? Yes No OK Question Title * 12. IF YES, PLEASE IDENTIFY THE LANGUAGE(S): OK Question Title * 13. WHY DO YOU THINK POLL WORKERS ARE IMPORTANT TO CONDUCT ELECTIONS? OK Question Title * 14. DO YOU FORESEE ANY PROBLEMS IN WORKING FROM 6:00 A.M. TO 8:30 P.M. (I.E. 14.5 HOURS) ON ELECTION DAY(S)? Yes No OK Question Title * 15. DO YOU FORESEE ANY PROBLEMS IN ATTENDING THE MANDATORY "IN-PERSON" POLL WORKER TRAINING CLASSES? Yes No OK Question Title * 16. I am not a convicted felon, or if I am, my rights related to voting have been restored. If I am duly appointed as a poll worker, a deputy, or an alternate in Fulton County, I will faithfully perform my duties to the best of my ability and according to the election laws of the State of Georgia. I understand that, as a poll worker, I serve at the will of the Supervisor of Elections and may be removed with, or without cause.OATH I do solemnly swear and affirm I do NOT solemnly swear and affirm OK Question Title * 17. SELECT DATE Date / Time Date OK Question Title * 18. WOULD YOU BE INTERESTED IN WORKING IN ANY OTHER CAPACITY IN THE ELECTIONS? Yes No OK Question Title * 19. PLEASE CHECK ALL THAT APPLY AS IT RELATES TO YOUR EMPLOYMENT BACKGROUND OR SKILL SET: ADMINISTRATIVE CUSTOMER SERVICE INFORMATION TECHNOLOGY Other (please specify) OK DONE