Application Form: 2024 BC Regional Health and Safety Conference

Together for Safety: Creating Healthier Workplaces, Building Better Lives

Please use this form to apply for the 2024 PSAC BC Regional Health and Safety Conference, which will be held in person October 18, 19 and 20 at the Pinnacle Hotel Harbourfront in Vancouver. 

The application deadline is Friday, September 6, 2024 at 11:59 PM Pacific.

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 or contact PSAC BC Staff Health and Safety Representative Jackie Pierre at

Personal information

Personal, not employer email please
or your home phone number if no cell

Workplace information

if you’re working remotely due to Covid, enter your usual or pre-pandemic workplace

Participant Profile

Important note: The responses to these questions will be used in the selection process for participants to the conference.

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

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.
For equity purposes, “person with disabilities” means persons who experience barriers arising from impairments of a physical, mental, sensory, psychiatric or learning nature.
A racially visible person in Canada is non-white in colour or race, regardless of place of birth.
An Indigenous person is a members of a First Nation, a Métis or an Inuit Community.
Two-Spirited, Lesbian, Gay, Bisexual, Transgender Persons, Queer, Intersex, Asexual


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

Loss of salary and expenses

The following information will only be used if you are selected as a participant to the conference.

Please identify if you will require loss of salary to be covered. In most cases, a full day will be needed to arrive in time for the program on Friday.

If you require Loss of Salary for Saturday or Sunday, please indicate below (for budget tracking purposes).

Accommodation for disabilities

The following information will only be used if you are selected as a participant to the conference.

The PSAC Accommodation Policy strives to ensure that PSAC Conferences 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 Conference.

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.

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.

On-site childcare is intended to remove a barrier to delegate participation at the Conference and is provided only for those who could not otherwise attend, had the service not been available. Requests must be received no later than Friday, September 6, 2024.

If there are any requests by participants, on-site childcare will be provided at the Conference for the activities outlined in the agenda.

Emergency contact

Last Section

With this application, I agree that, if selected, I will attend and participate in all sessions of the PSAC BC Health and Safety Conference scheduled for Friday to Sunday, October 18, 19 and 20, 2024. I have read the PSAC policy documents on harassment and scent-free environments and I understand my responsibilities in accordance with them.