Election Worker Application Form

BY-ELECTION WORKER POSITIONS - NOVEMBER 3, 2021 BY-ELECTION

Application Deadline: 4:00 p.m., Monday, September 20, 2021

Application Options:

1. To submit an online application, please scroll down; or
2. To print off a hard copy, click for PDF version. Submit your completed application one of three ways:
   • Mail your completed application to the Office of the City Clerk, City of Moose Jaw, 228 Main St. N., Moose Jaw, SK S6H 3J8; or
   • Scan and Email your completed application to elections@moosejaw.ca; or
   • Drop your completed application in the drop box at City Hall.

Individuals interested in applying for By-Election worker positions must demonstrate the following core competencies and be prepared to work long hours:

1. Basic literacy skills (reading, writing and comprehension)
2. Basic interpersonal skills, including the ability to exercise impartiality
3. Ability to serve voters that require assistance
4. Ability to perform repetitive tasks
5. Basic arithmetical skills
6. Basic analytical skills
7. Good attention to detail
8. Ability to adhere to directions and standards
9. Ability to learn in a short time frame

A valid email address is required for all By-Election workers. Communication to By-Election workers will be done by way of email.

Online Application

For information on remuneration, important dates, and job descriptions, click for PDF.

I am interested in being appointed as a By-Election Official for the 2021 Municipal By-Election.
The personal information collected on this form is collected under the authority of Section 24 of The Local Authority Freedom of Information and Protection of Privacy Act and will be used to determine suitability of the applicant for hiring as a municipal election worker for contact purposes and for payment purposes. For more information, contact the City Clerk’s Office at 306-694-4426.

*The following information is required in order to be considered:

Name *

Mailing Address *

City: *

Province: *

Postal Code: *

Phone: *

Email Address: *

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I would prefer to work as a (Indicate order of preference):

Poll Supervisor *

1

2

3

Not Interested

Deputy Returning Officer (Ballot Receiving Officer) *

1

2

3

Not Interested

Poll Clerk (Ballot Issuing Officer) *

1

2

3

Not Interested

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I am available to work on By-Election Day: *

Yes

No

I am available to work the Advance Polls: *

Yes

No

I am available to work the Hospital Special Poll: *

Yes

No

I am available to work the Mobile Polls: *

Yes

No

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Election Experience:

I have previous Election experience: *

Yes

No

Indicate whether you held the position of Poll Supervisor, Deputy Returning Officer or Poll Clerk:

Leave blank if you did not work a given election.

2020 Municipal & School Board Election Poll Supervisor Deputy Returning Officer Poll Clerk

2018 Municipal & School Board By-Election Poll Supervisor Deputy Returning Officer Poll Clerk

2016 Municipal & School Board Election Poll Supervisor Deputy Returning Officer Poll Clerk

Provincial Election(s) Poll Supervisor Deputy Returning Officer Poll Clerk

Federal Election(s) Poll Supervisor Deputy Returning Officer Poll Clerk

Other Election (Describe)

Total Number of Elections Worked (approximately) 1 2 3 4 5 6 7 8 9 10 More than 10

Skills and Abilities:

If you are human, leave this field blank.

Submit