Mississippi Election Protection Volunteer Application - Attorney
Full Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
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Please enter a valid phone number.
Email
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example@example.com
Occupation
Organization
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type NA if this does not apply to you
Title / Position at Organization
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type NA if this does not apply to you
Do you have experience with Election Protection?
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Yes
No
Are you bilingual?
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Yes
No
If so, list the languages below.
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Election Day Availability
Will you be out in the field or in the call center during the day?
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Field
Call Center
Time Availability
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7:00 AM - 10:00 AM
10:00 AM - 1:00 PM
1:00 PM - 4:00 PM
4:00 PM - 7:00 PM
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Election Protection Volunteer Code of Conduct
I warrant and represent that I am participating in this nonpartisan project to improve the election process, promote voter enfranchisement, and ensure that every vote counts as intended by the voters. I will not disrupt the election process or interfere in any way with the legal duties of poll workers and election officials. I understand the Election Protection Program is a nonpartisan effort and agree that during my volunteer shift I will not elicit or convey to any person seeking assistance any partisan information. I have read, understand, and agree to the Election Protection privacy policy described herein. To the extent the information disclosed to me by a caller to the hotline or by personnel working for the Election Protection Program is confidential or private in nature, I will not disclose such information without prior written authorization. Additionally, in the event that any confidential information or material relating to the entity(ies) hosting and supporting Election Protection Program activities is disclosed to me, whether or not such disclosure is voluntary or accidental, I shall not make any further disclosure of any such information or material. I shall keep confidential and follow established election incident reporting system procedures for handling of certain information, such as personally-identifiable information about callers who report election incidents. I will not redistribute private emails or other private communications without prior written permission from the person(s) whose private information would be disclosed by my actions. I will not knowingly engage in illegal distribution practices when posting information on election incident reporting. I shall release, defend, hold harmless and indemnify the MS Civic Engagement Roundtable coalition and its coalition members, partners, and other entities hosting or supporting the Election Protection Program activities, and their partners, members, employees and assigns, from and against any and all claims, demands, causes of action, losses, damages, liabilities, costs and expenses, including reasonable attorneys’ fees and costs, arising out of, resulting from or pertaining to any violation by me of this Code of Conduct; or any negligent or wrongful act or omission by me. I understand that any violation of this Code of Conduct may result in termination of my volunteer status and may have other negative consequences.
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By checking this box, I indicate my agreement with the above Code of Conduct.
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