Adopt-a-precinct interest Form

Interested in making a difference on Election Day while supporting your organization? The Adopt-A-Precinct program gives community groups and businesses the opportunity to staff a polling place, serve voters, and earn funds for scholarships, civic projects, outreach efforts, and more. Complete the interest form below to learn how your group can get involved.

1. Group’s Name

Group's Name(Required)

2. Group’s Address

Address(Required)

Street Address Address Line 2 City State ZIP Code

3. Group’s Phone Number

Group's Phone Number(Required)

4. Type of Group

Type of Group(Required)

Business

Church

College Student Organization

Fraternity or Sorority

High School Student Organization

Kiwanis Club

Masonic Lodge

Neighborhood/Community Association

Nonprofit Agency

PTA/PTSA

Rotary Club

Other

5. Coordinator’s Name

Coordinator's Name

First Last

6. Coordinator’s Email

Coordinator's Email(Required)

7. Coordinator’s Address

Only if different from group’s address, above.

Coordinator's Address

Street Address Address Line 2 City State ZIP Code

8. Coordinator’s Phone Number

Only if different from group’s phone number, above.

Coordinator's Phone Number

9. Preferred Area to Work in Orange County

Preferred Area to Work in Orange County

10. How did you hear about the Adopt-A-Precinct program?

How did you hear about the Adopt-A-Precinct program?(Required)

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