Subsidy Application Form for the NODL+KDLC WIL Course – non-PSAC Education Course

Please use this form to apply for an education subsidy to attend a non-PSAC courses. If you do not know your PSAC ID#, please call the Vancouver Regional Office at 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.
• The form will only allow you to apply for one subsidy at a time.

For further information, please contact Deanna Kimball, Regional Education Officer via email at kimballd@psac-afpc.com.

PSAC BC Education Subsidy Application – NOLC+KDLC Women In Leadership Course

Please use this form to apply for subsidies to attend a non-PSAC courses. If you do not know your PSAC ID number, please call the Vancouver Regional Office at (604) 430-5631 or 1 (800) 663-1655, and staff will look it up for you.

Please note: the fields marked with * are required. The form will not process your application if left blank.

Name *

First

Last

Email *

Cell Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

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PSAC ID number *

Component *Choose oneAgriculture UnionCanada Employment and Immigration UnionCustoms and Immigration UnionDirectly Chartered LocalGovernment Services UnionUnion of Canadian Transportation EmployeesUnion of Health and Environment Workers​Union of National Defence EmployeesUnion of National EmployeesUnion of Postal Communications EmployeesUnion of Safety and Justice EmployeesUnion of Taxation EmployeesUnion of Veterans' Affairs Employees

Branch or Local *

What Collective Agreement do you fall under? (Please choose an option in the drop-down list.) *AirportsBWXT MedicalCanada PostCBSA (FB)CFIACMHC Granville IslandCommissionairesCRAFNHAIMPNAV CanadaParks CanadaPLH DublinPurolatorTreasury Board (EB, PA, SV, TC)Statistics CanadaOther/Unknown

Course Information and Funding Request Details

Please note: PSAC BC does not provide subsidies to cover leave, loss of salary or provide Leave With Pay (LWP) letter for attending non-PSAC events or courses.

How much funding are you requesting from PSAC BC? *

Please provide a dollar amount.

Please provide a breakdown of your anticipated costs with a dollar amount for each item. *

(E.g. registration fee, travel costs, accommodations, meals (not included in the registration fee), mileage, and/or other expenses, etc.)

What other sources of funding have you obtained for this course? *

Please list all other sources of funding (e.g. you Local/Branch, Component, Area Council, Regional Committee, etc.)

What type of leave are you planning to take to attend this course? *

Why is attending the NOLC+KDLC Women In Leadership Course of value to you? *

For specialized training, please provide your involvement in the field of study/subject matter.

How will you utilize the learning and course information in your union activism? *

I am an active member of a: *

• PSAC Regional Women’s Committee
• PSAC Human Rights Committee
• PSAC Young Workers Committee
• PSAC Area Council
• PSAC BRUSH (Health and Safety) Committee

Please select all that apply.

Do you commit to providing a written report to the PSAC Regional Education Officer and REVP's Office within thirty (30) days of completing the course? *

• Yes
• No

Equity Designation

PSAC members who belong to the following groups are invited to provide their equity designation(s). This information is voluntary and kept confidential. Please check all that apply.

I am a person with a disability

• Yes

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

• Yes

An Indigenous Person is a member of a First Nation, a Métis or an Inuit community.

I am a Racialized Person

• Yes

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

I am a member of the 2SLGBTQIA+ community

• Yes

Two-Spirited, Lesbian, Gay, Bisexual, Transgender Persons, Queer, Intersex, Asexual

I self-identify as a woman

• Yes

I am 35 years of age and under

• Yes

What is your year of birth?

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

Submit