2021 PSAC BC ACTIVIST SUMMIT: Building Activism by Building Our Membership – application form

Please use this form to apply for the 2021 Activist Summit.

Provide the address you would like used for all correspondence for the Summit – should not be an employer email.

Participant Profile

Important note: The responses to the questions below will be used in the selection process for delegates and observers to the Summit.

Indicate in years/months if possible.
Please indicate the event(s) and what year(s) you attended.
Please indicate the course(s) and what year(s) you attended.
Please specify which one(s)
In 150 words or less
In 150 words or less

Voluntary Equity Group and Young Workers Self-ID

PSAC members who belong to the following groups are invited to self-identify. This information is voluntary and kept confidential and will be used for the purposes of supporting our equity initiatives and programs.

This information may be shared with different structures of the union in support of our human rights work only.

Advance / Leave With Pay

Emergency Contact Information

In the unlikely event that we need to contact someone on your behalf, please provide the contact information for an emergency contact.

Going Green at our Summit

Climate change, global warming and the protection of our environment are union issues. PSAC events and meetings all have an impact on our environment. We can help reduce this impact by adopting environmentally-friendly practices. PSAC has worked to create more sustainable union events to reduce our carbon footprint. Our actions have included reducing the amount of paper and materials distributed, and recycling and reusing materials. Together, we can make a difference.

As part of these efforts, electronic copies of all Summit materials will be provided to participants.

Accommodation for Disabilities

The PSAC Accommodation Policy for delegates at PSAC events strives to ensure that events are barrier-free for delegates with disabilities. Once selected, members may be required to further specify their accommodation needs in order to facilitate their participation at these union activities.

You may be required to provide relevant medical documentation that will assist us to respond to your request. This information will not be disclosed except where necessary to respond to your request for accommodation.

You are not obliged to disclose your diagnosis, only your functional limitations.

Family Care for Participants

The objective of the PSAC Family Care Policy is to remove one of the barriers which prevents delegates from participating fully in union activities and which provides for the reimbursement of family care expenses. A copy of the policy is available at www.psacunion.ca/family-care-policy

Requests must be received no later than November 5, 2021.

We will follow-up if we require additional information.

Thank you for completing the application form!