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City Clerk Jennifer A. Zelmanski
Must be a recognized party in the State of Michigan & may NOT be Independent.
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1= Not Experienced 5=Very Experienced
Please check all that apply.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I further certify that I am not a member or a known active advocate* of a political party other than the party identified above. The foregoing statements are true to the best of my knowledge and belief.
* A "Known active advocate" of another political party is defined to mean a person who 1) is a delegate to the convention or an officer of another party; 2) is affiliated with another party through an elected or appointed government position; or, 3) has made documented public statements specifically supporting by name another political party or its candidates in the same calendar year as the election at which the person will serve as an election inspector. "Documented public statements" means statements reported by the news media or written statements with a clear and unambiguous attribution to the applicant.
APPROVED BY THE STATE DIRECTOR OF ELECTIONS
If you choose to print this application, please mail or hand deliver it to:
City Clerk's Office
c/o Jennifer A. Zelmanski, City Clerk for the City of Roseville- 29777 Gratiot Avenue, Roseville, MI 48066.
Any False Statements made on this application will disqualify the applicant.
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