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ELECTION WORKER
ON-LINE APPLICATION FORM
First Name:
Last Name:
Address:
Postal Code:
Home Phone:
Work Phone:
Cell Phone / Email:
What is your current employment status? (check all that apply)
Student:
Work full-time:
Work part-time:
Retired:
Self-employed:
Other:
Personal information on this form is collected under the authority of
The Municipal Councils and School Boards Election Act
and will be used solely for election purposes.
Last update: 2009/01/20