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3. 

5. Please contact Nye County Clerk Mark Kampf with any questions at 775-482-8134 or email mkampf@nyecountynv.gov

7. First Name*
8. Middle Name
9. Last Name*
11. Email*

    Email is required and must be verifiable.

12. Phone
14. Physical Address*
16. Town
17. State
18. Zip
20. Mailing Address if different than physical address
22. Town
23. State
24. Zip
26. I am registered to vote in Nye County. *

    1. Yes
    2. No

    If not, you can register to vote online at www.registertovotenv.gov

28. Do you have prior experience as an election worker?*

    1. Yes
    2. No
30. If so, what where your duties?
32. Do you have experience working on a laptop computer?*

    1. Yes
    2. No
34. Do you have data entry experience?*

    1. Yes
    2. No
37. 
39. Type name below

41. Please contact County Clerk Mark Kampf with any questions at 775-482-8134 or email mkampf@nyecountynv.gov

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43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field