Poll Worker Application

Application to Serve as a Poll Worker in your county for Kentucky.
By filling out the following form you agree to be contacted by your County Clerk by email or phone.

First *

Middle

Last *

Address *

City *

State *

Zip *

Birth Date *

Phone Num *

Email Addr

Click HERE for more information about becoming a Precinct Worker.

Privacy Information:

This information is for official use only. Any unauthorized release may be punishable by law.
Your electronic mail address and social security number are exempt from disclosure.