Application Form: 2021 BC Regional Health & Safety Conference

Where does the employer’s responsibility end and ours begin?

Please use this form to apply for the 2021 B.C. Regional Health and Safety Conference, which will be held virtually, March 19, 20, 21. Application deadline: March 5, 2021

Note fields marked * are required.

If you have any questions about the Health and Safety Conference, please call the PSAC Vancouver Office at (604) 430-5631 or 1 (800) 663-1655.

    Union Activities

    Yes, PSAC Regional H&S Conference(s)Yes, PSAC National H&S Conference(s)Yes, Component H&S Conference(s)No

    Training/Participation

    YesNo

    YesNo

    YesNo

    Written Submission

    Wages/Travel/Family Care

    YesNo

    We encourage members applying for this Health & Safety Conference to request leave with pay, given the joint nature of union-management responsibilities in this area. If your leave with pay request is denied, please apply for leave without pay for union business and we will cover your loss of salary.

    YesNo

    YesNo

    Additional Accessibility Requirements

    The PSAC is committed to ensuring that the accessibility needs of our members are respected. If you have any persistent or permanent physical, mental, learning or sensory impairment as recognized under the Canadian Human Rights Act and have additional needs that you require accommodation for, please complete the attached request for accommodation of a disability section below. (i.e. special diet; use of a wheelchair, walker or crutches; blind or visually impaired; deaf or hearing impaired; need assistance leaving room in an emergency; allergies). You may also be required to provide relevant medical documentation that will assist us in responding to your request. This form is confidential when completed and the information contained within will not be disclosed except where necessary to respond to your request for accommodation.

    Self ID (optional)

    The PSAC is committed to ensuring that our education programs are accessible to all members. The information requested in this section will help us assess our success in reaching members who belong to groups identified in the PSAC Human Rights Policy. 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

    Harassment policy

    Harassment-free: All PSAC events, including this conference, are covered by the PSAC Statement on Harassment.

    Last Section

    With this application, I agree to attend and participate in all sessions and to complete all assignments. I have read the PSAC policy documents on harassment and scent-free environments and I understand my responsibilities in accordance with them.

    YesNo