2025 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? *

Participant Profile

To ensure the Summit responds to the needs of members, we invite you to complete the following questions.

This is my first time attending the PSAC BC Area Council and Regional Committee Summit *

If you have attended (a) Summit(s) in the past, what dates did you attend?

What questions (on Area Councils or Regional Committees) do you have that you're hoping the Summit will address?

What challenges does your Area Council or Regional Committee have that you'd like to explore at the Summit?

What's one area or subject that you're hoping to gain more informaton on to support your work with you Area Council or Regional Committee?

Loss of salary and expenses

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

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

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.

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.

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

Family Care

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 on the PSAC website here.

I will require family care expense reimbursment for my attendance at the Summit. *

Please provide details.

Emergency contact

Name *

Relationship to the Participant *

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

If yes, what is your date of birth?

I am a member of the 2SLGBTQIA+ community

2SLTGBTQIA+ is defined as Two-Spirited, Lesbian, Gay, Bisexual, Transgender Persons, Queer and/or Questioning, Intersex, Asexual, with a plus to encompass other forms of sexual orientation and gender expression, such as gender queer or gender nonconforming persons.

I am a racialized person

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

I am a person with a disability

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

I am an Indigenous person

An Indigenous person is a member of a First Nation, a Métis or an Inuit Community.

Pronouns

Please indicate your pronouns (she, he, they, zhe, etc.) above. More information on pronouns and building trans-inclusive workspaces can be found here.

With this application, I agree that, if selected, I will attend and participate in all sessions of the PSAC BC Area Council and Regional Committee Summit scheduled for Thursday, March 27, 2025. I have read the PSAC policy documents on harassment and scent-free environments and I understand my responsibilities in accordance with them.

Topics:

Bargaining Treasury Board