Protect the Vote – Volunteer Form

Contact Information

Name:
Street Address:
City:
ST:
Zip:
Home Phone:
Work Phone:
Cell Phone:
E-Mail Address:
Occupation:
Do you have experience with PTV?: Yes No 
Are you bilingual? If so, list languages:

Availability

If you are volunteering for Election Day, please check the time(s) you are available:
 7:00 AM to 10:00 AM  10:00 AM to 1:00 PM
 1:00 PM to 4:00 PM  4:00 PM to 7:00 PM  All day

Are you available any other days that week?
 Monday Wednesday Thursday Friday

Interests (call center, field, watch party)

 Registration
 CC Phone Operator
 CC Complaint Logging
 CC Expert Panel
 CC Blogger
 Field Team Leader. Preferred County:
 Field Dispatch Team. I am willing to travel. Preferred County:
 Video the Vote
 WP Child Care
 Floater

Person to Notify in Case of Emergency

Name:
Phone:

Protect the Vote 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 Protect the Vote 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 Protect the Vote privacy policy described herein. To the extent the information disclosed to me by a caller to the hotline or by personnel working for the Protect the Vote 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 Protect the Vote 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 State Conference NAACP and its officers, directors, employees and assigns, and other entities hosting or supporting Protect the Vote 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.


By checking this box, I indicate my agreement with the above Code of Conduct.