Precinct Officer Application Form - Fresno County Clerk-Elections Department
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1
2OFFICE USE ONLY
Date Received: ______________________
Precinct Officer Application
ID Number
_______________________
Fresno County Clerk-Elections Department
Reg. Number: ______________________
2221 Kern Street
Fresno, CA 93721
Legal Resident _______________________
(559) 600-1620
Fax (559) 488-3279
To qualify as a Precinct Officer you must be able to read and write English, and be one of the following:
18 years old, a registered voter in the State of California, and a U.S. Citizen; or
18 years old, and a Legal Resident of the United States living in California; or
16 years old, a Junior or Senior in High School with a GPA of at least 2.5. Submit a Student Precinct
Officer Application signed by a parent or guardian, and a teacher. Call 600-1620 for more information.
PLEASE PRINT CLEARLY
First Name: ________________________________ Last Name: _________________________________
Address: ______________________________ City: _____________________ Zip Code: ____________
Date of Birth: _____________________ Email: _______________________________________________
Mailing Address: ________________________________________________________________________
Home: __________________ Cell: __________________ Work: ________________________
Please specify your primary contact phone number
Yes
No
Please answer the following questions:
Are you available to attend the required 2-hour training prior to Election Day?
Are you willing to work in a location outside your home precinct?
Have you ever served as an election officer before?
If yes, when and where did you serve? ______________________________________________
Are you a candidate on the ballot for this election?
If yes, which office? ______________________________________________
Are you related to any candidate on the ballot for this election?
If yes, which office? ______________________________________________
Are you fluent in any language other than English? Fresno County is required to provide language
coverage in Spanish, Chinese, Japanese, Khmer, and Hindi (Punjabi). EC 14201(d)
If yes, what languages(s)? _________________________________________________________
Do you have a cell phone you would be willing to use on Election Day?
I declare under penalty of perjury, that all the above information is true and correct to the best of my
knowledge.
Signature: __________________________________________ Date: _______________________________
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