IN ORDER TO FINALIZE THE APPLICATION PROCESS YOU ARE REQUIRED TO COMPLETE AN ADDITIONAL FORM, THE ‘ELECTION WORKER QUESTIONNAIRE’, IN PERSON MONDAY – FRIDAY BETWEEN 8:30AM AND 4:00PM AT THE ELECTIONS AND CENSUS OFFICE (16304 – 114 AVENUE). QUESTIONNAIRES ARE AVAILABLE STARTING JUNE 12, 2017.
Please ensure all fields are completed

PERSONAL INFORMATION
LAST NAME: APT.#:(optional)
FIRST NAME: HOUSE #:
PRIMARY PHONE:
STREET / AVENUE NAME:
ALTERNATIVE PHONE #:(optional)
QUADRANT:
EMAIL ADDRESS: CITY:
POSTAL CODE:
EMERGENCY CONTACT INFORMATION
NAME: PHONE #:
RELATIONSHIP:
Can the Election and Census office retain your personal information in order to contact you for future elections?
Can the Election and Census office retain your personal information in order to contact you for future censuses?
Do you have City of Edmonton election work experience?
(i.e.: Election Day, Advance Vote, Hospital Voting, Senior Accommodation Facilities etc.)
Do you have other election experience?
Are you fluent in English?
Are you fluent in any other languages?
Are you willing to work anywhere in your ward, if required?
Are you willing to work in an alternate ward, if required?
Please select three positions you are most interested in working:
Select 1st Choice:
Select 2nd Choice:
Select 3rd Choice:
Are you willing to accept any position other than those that you have indicated above?
Some positions require you to have a personal vehicle with proof of insurance and a valid driver’s licence. Do you have a personal vehicle with proof of insurance and a valid driver’s licence?
Some positions require you to be able to lift and carry items weighing approximately 30-60lbs (13-27kg), are you able to lift and carry items weighing approximately 30-60lbs (13-27kg)?
Do you require any accommodations to perform the duties of the position(s) that you are applying for? (please refer to job description)
How did you hear about these positions? (please check one)
Once hired, all election workers are required to attend a training session at the Elections and Census office. What time of day would you prefer to attend training?
I prefer to receive correspondence from the Elections & Census Office via: (please check one)
Are you currently employed by the City of Edmonton?
I certify that all statements made in this application are true and correct to the best of my knowledge. I understand that my employment as an election worker may be terminated without notice or compensation if it is determined that I have made any false or misleading statements in this application, or after my appointment as an election worker. I authorize the City of Edmonton to verify all statements contained in this application.
Signature:
Verification Code:
The personal information on this form is being collected for selection and hiring, position assignments, voting station identification, remuneration and future election or census worker opportunities, and is authorized under Section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions concerning the collection of this personal information, please contact Linda Sahli, City Clerk at 780-442-VOTE(8683).