PART-TIME EMPLOYMENT APPLICATION
THE Board of Election Commissioners for the City of Chicago is an equal opportunity employer. Must be a resident of Chicago.  Part-time employment is defined as no more than 30 hours per week  
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Name *
First and last name
Address *
Zipcode *
Email *
Home Phone
Cell Phone *
Birth Date
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DD
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Are you eligible to work in the U.S? *
Required
Are you a resident of the City of Chicago? *
Required
You must be fully vaccinated.  (2 weeks after 2nd shot of Pfizer or Moderna or 1 shot J&J)  Are you able to provide proof of vaccination? *
Required
* Please provide specific hours you are available to work (Ex. 8:00 AM – 6:00 PM):  
Monday *
Tuesday *
Wednesday *
Thursday *
Friday *
Saturday *
Sunday *
Have you ever been employed by the Chicago Board of Election Commissioners? *
Required
If yes, when and what election/position/department:  (Judge, EV, Coordinator)
Are you related to anyone who works for the Board of Election Commissioners? *
Required
If yes, please list their name and department:
Please list any skills such as data entry, languages spoken, warehouse, any computer programs:
What is your highest level of education? *
Required
Position Desired(Ex. Warehouse, Clerical or Data Entry) *
Date Available to Start *
MM
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DD
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YYYY
Are you currently employed? *
Required
If yes From (MM/YYYY) to Present: 
MM
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DD
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What is your position? 
May we contact your present employer?
If yes, please provide Employer Name, Address, City, State 
Name of Supervisor and phone number and email 
Previous Employer Name, Address, City, State  *
Name of Supervisor, phone number and email  *
From/To Dates (MM/YYYY) *
Reason for Leaving *
Previous Employer Name, Address, City, State 
Name of Supervisor, phone number and email 
From/To Dates (MM/YYYY)
Reason for Leaving
Please provide 3 references (2 must be professional):
Name *
Phone, Email *
Years Aquainted *
Type of reference *
Required
Name *
Phone, Email *
Years Aquainted *
Type of reference *
Required
Name *
Phone, Email *
Years Aquainted *
Type of reference *
Required
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the Chicago Board of Elections to hire me.  I certify that the facts contained in the application are true and that all information on this application is subject to verification and the educational institutions, former employers and references may be contacted regarding this application.  If I am offered a position, I understand that I may be subject to a criminal history back ground check.  If any information I have provided is untrue or if I have concealed material information, I understand that this will constitute cause for denial of employment or immediate dismissal.
Applicant Initial
*
Date *
MM
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DD
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YYYY
How did you hear about this opportunity?
*
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