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Poll Worker Training Completion Form

2. First Name*

3. Last Name*

5. Precinct Number*
   -- Select One --1 - DUNNAVANT COMMUNITY CENTER2 - VANDIVER-STERRETT SENIOR CENTER3 - TURNER-HOLLIS AMERICAN LEGION POST #1954 - VINCENT REVIVAL CENTER5 - HARPERSVILLE CITY HALL6 - WESTOVER NEW LIFE ASSEMBLY OF GOD7 - CHELSEA CHURCH OF GOD 8 - NORTH SHELBY BAPTIST CHURCH9 - ASBURY UNITED METHODIST CHURCH10 - BLACKWATCH SPORTS PERFORMANCE11 - SHOAL CREEK TOWN HALL12 - GREYSTONE FARMS CLUBHOUSE13 - HOOVER FIRE STATION #8 (HOOVER)14 - THE CHURCH AT BROOK HILLS15 - MEADOWBROOK BAPTIST CHURCH16 - NEW HOPE CUMBERLAND PRESBYTERIAN CHURCH17 - FIRST CHRISTIAN CHURCH18 - VALLEYDALE BAPTIST CHURCH19 - RIVERCHASE CHURCH OF CHRIST20 - PELHAM CIVIC CENTER21 - HELENA COMMUNITY CENTER22 - SOUTHCREST BAPTIST CHURCH23 - CHURCH OF JESUS CHRIST OF LATTER DAY SAINTS24 - RESTORE-1ST UMC OF ALABASTER25 - LIBERTY BAPTIST CHURCH (ALABASTER)26 - EVANGEL PRESBYTERIAN CHURCH27 - FIRST PRESBYTERIAN CHURCH ALABASTER28 - CHELSEA COMMUNITY CENTER29 - PELHAM PARK RECREATION CENTER30 - STEWART RETREAT CENTER31 - PEA RIDGE COMMUNITY CENTER32 - RIVERCHASE BAPTIST CHURCH33 - MONTEVALLO PARK & REC BUILDING34 - ROY DOWNS MEMORIAL CALERA LIBRARY 35 - CONCORD BAPTIST CHURCH36 - CAMP BRANCH CIVIC CENTER37 - COLUMBIANA RECREATION CENTER38 - FOURMILE VOLUNTEER FIRE & RESCUE DEPT.39 - WILSONVILLE UNITED METHODIST CHURCH40 - SHELBY IRON WORKS PARK41 - BAY SPRINGS BAPTIST CHURCH42 - CHRIST CHURCH UNITED METHODIST43 - FAITH PRESBYTERIAN CHURCHFloater / Absentee

6. Position*
   -- Select One --InspectorChief ClerkAssistant

8. Email Address*

9. Phone Number*

11. Which training videos have you reviewed?*

    1. Video 1 – Poll Worker General Instructions
    2. Video 2 – Preparing to Open the Polls
    3. Video 3 – Voter Processing (Identification, Poll Books, and Voter Check-ins)
    4. Video 4 – Closing the Polls
    5. Video 5 – Inspector Training (Ballot Accounting Form, Provisionals, Advanced Poll Book Functions)

    Poll Workers are required to complete Videos: #1, #2, #3, and #4. Inspectors are required to complete ALL Videos.

13. I hereby acknowledge, by my signature below, that I have completed all Poll Worker Training Videos required for my position. I further acknowledge that providing false information on this form shall result in my disqualification for appointment as a Poll Worker or Precinct Inspector in future elections.

15. Enter Name*

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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

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