Application Form to work on Elections/Canvass
1. Personal Details
Name
*
First Name
Last Name
Personal Email Address
*
example@example.com
Mobile Phone Number
*
Please enter a valid phone number.
Format: 00000000000.
Work Phone Number
Please enter a valid phone number.
Format: 00000000000.
Home Address
*
Street Address
Street Address Line 2
Town
County
Post Code
Date of Birth
*
-
Day
-
Month
Year
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National Insurance Number
*
2. Elections/Canvass Work
Which of the following jobs would you like to be considered for? Please tick the appropriate box(es) below:
*
Presiding Officer
Poll Clerk
Count Assistant
Household Canvass
Which of the following jobs do you have experience of? Please tick the appropriate box(es) below:
*
Presiding Officer
Poll Clerk
Count Assistant
Household Canvass
I have no experience
Have you worked on elections previously? If so, where, when and in what capacity?
*
Please briefly outline relevant experience and skills pertinent to the roles:
*
Are you willing to work anywhere in the Borough? If not which areas would you prefer to work in? Please note that although we will endeavour to accommodate your request, we cannot guarantee that you will be placed specifically where asked.
*
5. Declaration
I confirm that the information that I have provided on this Application Form is accurate. I understand that my personal details will be stored in a database and I will be contacted at the time of an election if there is a suitable vacancy, which could be at short notice.
*
I confirm
Today's Date
*
-
Day
-
Month
Year
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Privacy Statement
Details of Surrey Heath Borough Council’s Privacy Notice can be found
here
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