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Poll Manager Application

  1. Do you have reliable transportation?
  2. Have you ever worked at a polling precinct
  3. Are you willing to work outside your own precinct?
  4. Are you able to work from 6:00 am to 8:00 pm on Election Day?
  5. Have you ever been convicted of a felony?
  6. I consider myself to be
  7. I, the undersigned, understand that if hired as a poll manager, receiving manager, bailiff or any other position at the polling precinct, I will be required to attend training classes held by the Desoto County Election Commission and/or the Mississippi Secretary of State.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  8. Electronic Signature*
  9. Leave This Blank:

  10. This field is not part of the form submission.