2022 PSAC BC Regional Women’s Conference Application

“Bridging the Gap Between Talk and Action”

The 2022 PSAC BC Regional Women’s Conference, will be held November 25-27 at the Sheraton Richmond Hotel. This conference is fully funded event for delegates.

Please ensure that you answer all the questions on the registration form to avoid any delay in processing your application. Application deadline: Friday October 7, 4PM PT.

Applications received after the deadline will not be accepted.

If you have any questions with respect to the application form or the Conference, call 604-430-5631 or toll-free in B.C. at 1-800-663-1655. If necessary, please leave a voicemail or email DucharP@psac-afpc.com

I am a PSAC B.C. member who self-identifies as a Woman *

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

Workplace information

Component / DCL *

Local / Branch number *

Worksite address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

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

Participant Profile

This is my first PSAC Conference *

Have you ever attended a PSAC Regional Women’s Conference? *

Have you ever attended a PSAC National Women’s Conference? *

Are you currently a member of a PSAC Regional Women’s Committee? *

Please list your involvement with any other Union activities or community groups that actively work on Women’s issues. *

We would love all applicants to attend, but we have limited seats. Tell us in your own words why is it important for you to come to this Conference? *

After the Women’s Conference, how would you support your Regional Women’s Committee? *

Loss of salary and expenses

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

If selected as a participant, I will require an advance for expenses associated with this event. *

Accommodation for disabilities

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.

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 members 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 at www.psacunion.ca/family-care-policy.

On-site childcare is intended to remove a barrier to 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 October 21, 2022.

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

I require on-site child care

Emergency contact

Name

Emergency contact phone number

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

I am racially visible

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

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 an Indigenous person

Last Section

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

With this application, I agree that, if selected, I will attend and participate in all sessions of the PSAC B.C. Regional Women’s Conference