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Employee Details Forms for Election Duty

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Employee Details Forms For

Election Duty
Personal Information
Full Name: __________________________________________________
Employee ID: __________________________________________________
Position/Title: _______________________________________________
Department: ___________________________________________________
Contact Number: _______________________________________________
Email Address: ________________________________________________

Election Duty Assignment


Assigned Location: ____________________________________________
Duty Role: ____________________________________________________
Election Date: ________________________________________________
Training Date (if applicable): _________________________________

Emergency Contact Information


Contact Name: _________________________________________________
Relationship: _________________________________________________
Contact Number: _______________________________________________
Alternate Contact Number: ______________________________________

Health Information (Optional for Emergency Use)


Allergies (if any): _____________________________________________
Medical Conditions: ____________________________________________
Preferred Hospital (in case of emergency): ______________________

Vehicle Information (If Using Personal Vehicle for Duty)


Vehicle Type: _________________________________________________
License Plate Number: _________________________________________
Driver's License Number: ______________________________________

Acknowledgment and Consent


I, [Employee's Name], hereby confirm that the information provided above is accurate
and complete to the best of my knowledge. I understand that this information will be
used for the purpose of organizing and managing election duty assignments and for
emergency use during the election period.

Signature: _______________________________ Date: _______________

For Office Use Only


Form Received By: ________________________ Date: _______________
Comments: ______________________________________________________

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