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2. First Name
3. Last Name
5. Phone Number
7. Address 1
9. Address 2
11. City
12. State
13. Zip
15. Are you a candidate, spouse of a candidate, immediate relative of a candidate, or connected to a campaign?*

    1. Yes

    1. No
17. Please check all types, if any, of election you have worked in:

    1. Federal

    1. Municipal

    1. Provincial
19. What is your current position or previous employment?*
    Position and Employer
21. Are you willing to attend a training session prior to voting day?*

    1. Yes

    1. No
23. Do you have access to a vehicle and a valid driver's licence on voting day and/or advance poll dates?*

    1. Yes

    1. No
25. I declare that the information provided by me in this application for employment is, to the best of my knowledge, an accurate statement of the facts. I understand that falsified statements on this application shall be considered sufficient cause for dismissal.

    1. I agree to the terms and conditions listed above.
27. Only successful applicants will be contacted by the Clerk's Office. If successful, elections staff are asked to vote on advance poll dates.
    
    Information on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act and will be used exclusively for the purposes of the 2013 County of Stettler Municipal Election.
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field