Bay County Clerk

Cynthia A. Luczak

Bay County Building
515 Center Avenue, Ste. 101
Bay City, Michigan 48708-5941
Voice: (989) 895-4280
Fax: (989) 895-4284
luczakc@baycounty.net

Poll Worker Interest Form

Contact Information

First Name*
Last Name*

 

Address 1

 

Address 2

 

City
State
Zip

 

Phone Number*
Emaill Address*

 

I am interested in serving as a Poll Worker in the following location:

Please select ONE first choice. You may provide additional choices in the text box below.

 City of:

 

Township of:

 

Other cities / townships I would consider working in if my first choice is full:

 


A poll worker must be a registered voter in the State of Michigan. Exception: individuals age 16-17 not yet registered to vote but who will be qualified to register to vote when they meet the minimum age may serve as poll workers. A poll worker cannot be a challenger, candidate, member of a candidate's immediate family, or a member of the local Board of Canvassers. Anyone convicted of a felony or an election crime may not serve.

Please note that if your requested location is not in need of poll workers your information may be passed along to another city or township where poll workers are needed.

 

Please validate by entering the text from the image below into the provided field.
YOU WILL THEN BE ABLE TO CLICK THE SEND BUTTON TO SUBMIT YOUR FORM.