PSAC BC Education Application Form – Anti-Oppression and Anti-Racism sessions with Bakau Consulting

If you do not know your PSAC ID#, call the Vancouver RO @ 604 430-5631 or 1 800 663-1655 and we will look it up for you.

Please note

The fields marked with a * are required – the form will not process your application if left blank.
Deadline for applications is Monday, March 15, 2021 at 4:00 p.m. (PST)

Your Name*

Primary email*

PSAC ID*

Component or DCL*

Work phone*

Cell phone

Alternate email address

Home phone

Street address*

City*

Postal Code*

Province*

Worksite Address

Street address*

City*

Postal code*

Province*

Optional 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 racially vibisle

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

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.

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 am a member for the LGBTQ2+ community

I am 35 years of age and under

If yes what is your year of birth?

Course Application Questions

Are you committed to attending all three sessions? *Yes - Session 1: Fundamentals of Anti-oppression Wed. March 31, 2021Yes - Session 2: Anti-racism/Intro to Racial Justice Wed. April 21, 2021Yes - Session 3: Unlearning anti-Blackness Wed. May 12, 2021

Please check each box to confirm your commitment of attending all three sessions.

Why do you want to attend these sessions?*

500 words or less, please.

How do you do incorporate Anti-Racism into your day to day life? **

500 words or less, please.

Last Section

Will you be claiming loss of salary OR leave with pay as specified by the Treasury Board, Parks and CFIA collective agreements?*YesNo

If yes, please specify the date(s) and time(s)

Do you have any special requirements?YesNo

If yes, please specify

Please confirm that you will receive handouts and relevant readings electronically for the course by checking this box:Yes

PSAC Education is committed to greening our events and would like to reduce the amount of paper waste produced at our education events. Climate change, global warming and the protection of our environment are union issues. Conventions, conferences and meetings all have an impact on our environment. We can help reduce this impact by adopting environmentally-friendly practices.

If you require printed materials, as a part of an accommodation, please check this boxYes

Emergency Contact

Name*

Phone number*

Optional

Is there anything else you would like to add to your application?