2023 Ward 8 By-Election Official Application

First Name

Last Name

Address

Postal Code

Email

Daytime phone #

Evening Phone #

Cell Phone #

What position(s) are you interested in?

Supervisory Deputy Returning Officer

Deputy Returning Officer

Poll Clerk

What is your preferred polling accommodation(s)?

Election Day Poll (8 a.m. to approximately 10 p.m.)

Advance Poll (May 18 from 4 to 8 p.m. and May 27 from 1 to 4 p.m.)

Do you have election experience?

Yes

No

If you have previous experience, please indicate which position, or describe within "other". (Check all that apply)

Supervisory

Deputy Returning Officer

Poll Clerk/Information Officer

Other

Do you have a current valid Saskatchewan driver's license?

Yes

No

Do you have a disability or require special accommodations to perform any of the responsibilities of the position you are applying for?

Yes

No

How did you hear about our employment opportunity?

Social media

Internet/city website

Newspaper

Radio

Word of Mouth

Other

Do you wish to disclose your personal contact information to Elections Saskatchewan or Elections Canada for the purpose of being informed of future election employment opportunities?

Yes

No

Skill testing Question

1. Candidate A received a total of 233 votes; Candidate B received a total of 322 votes; Candidate C received a total of 232 votes. Please tally the number of valid votes cast by filling out the sections below.

Candidate A

Candidate B

Candidate C

Total

2. What is the answer to 4+6+18?

Would you like us to contact you to work the 2024 Municipal election?

Yes, please

I hereby declare that all statements made in this application are true and complete to the best of my knowledge and belief. I understand that any misrepresentation of information may result in my application being disqualified.

Yes

No

Date

Signature

Clear

The City of Prince Albert is committed to protecting your privacy. Personal information collected on this form is in accordance with The Local Authority Freedom of Information and Protection of Privacy Act (LAFOIP) and will only be used for the purpose for which it was collected. Personal information will not be shared or used for any other purpose without your express consent pursuant to LAFOIP and the City of Prince Albert’s policies. Please contact The City Clerk’s office, 1084 Central Ave., Prince Albert, SK, via email cityclerk@citypa.com or call 306-953-4305 for questions about the access, use, and disclosure of your personal information.

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2023 Ward 8 By-Election Official Application