Skip to content

Navigation

Discover
Events
Topics
Contact

2024 PSAC B.C. Area Council and Regional Committee Summit

Please fill in this form to help us plan for the Summit.

Personal information

Name *

First

Last

Email *

Personal, not employer email please

PSAC ID number *

Cell phone *

or your home phone number if no cell

Work phone *

Home address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Which Area Council or Regional Committee are you representing? *

What is your position on the Area Council or Regional Committee Executive? *

Loss of salary and expenses

Will you be claiming loss of salary OR leave with pay as specified by your collective agreement? *

Yes
No

Please specify the date(s) and times(s)

I will require an advance for expenses associated with this event. *

Yes
No

Accommodation for disabilities

The PSAC Accommodation Policy strives to ensure that PSAC Summits are barrier-free for members with disabilities. Once selected as a participant, members will be asked to specify their accommodation needs in order to facilitate their participation at this Summit.

I am a member with a disability and require accommodation.

Yes

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.

What are the functional limitations arising from your disability?

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

I require that the PSAC arrange for a personal care attendant to assist me in order for me to fully participate at the Summit.
I require documentation in alternative media.
I require sound amplification.
I require sign language interpretation.
I require an oral interpretation.
I require that the PSAC arrange for a Reader (for a person with a visually related disability) to assist me in order for me to fully participate at the Summit.
I will be using animal assistance (i.e. guide dog) at the Summit.

If you require specific accommodation for a disability in your hotel room, specify here

The PSAC has reserved a block of rooms at the Sheraton Vancouver Airport Hotel for delegates in travel status. This hotel is unionized and accessible.

If you have dietary requirements or allergies that the PSAC should be aware of, specify them here

Emergency contact

Name

Emergency contact phone number

Optional equity 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. Please check all that apply.

I am 35 years of age and under

Yes

If yes, what is your date of birth?

I am a member of the 2SLGBTQIA+ community

Yes

I am racially visible

Yes

A racially visible person in Canada is non-white in colour or race, regardless of place of birth.

I am a person with a disability

Yes

For equity purposes, “person with disabilities” means persons who experience barriers arising from impairments of a physical, mental, sensory, psychiatric or learning nature.

I self-identify as a woman

Yes

I am an Indigenous person

Yes

Topics:

Bargaining Treasury Board

Join our mailing list

Vancouver Regional Office

200 - 5238 Joyce Street,

Vancouver BC V5R6C9

Tel: (604) 430-5631

Toll-free: 1 (800) 663-1655

Victoria Regional Office

Suite 202 - 503 Park Place,

Victoria BC V9A 3P1

Tel: (250) 953-1050

Toll-free: 1 (866) 953-1050

Privacy Policy |

Copyright 2020