Ontario Virtual Regional Convention 2021 Registration Form

DEADLINE FOR REGISTRATION: March 11, 2021

DEADLINE FOR RESOLUTIONS: March 11, 2021

Please ensure that you answer all the questions on this registration form to avoid any delay in processing your application

**NOTE: LATE APPLICATIONS WILL NOT BE ACCEPTED**

Personal Information*

(provide the address you would like used for correspondence for this conference – should not be an employer email)
(if different from above)

Certification/Credentials*

The local president/committee chair certifies that the above-named member has been chosen by our sending body.
(please indicate name of Committee i.e. Barrie RWC)
(please indicate name of Committee i.e. Barrie RWC)
(please indicate name of Committee i.e. Barrie RWC)
(please indicate name of Committee i.e. Barrie RWC)
(please indicate name of Committee i.e. Barrie RWC)

Voluntary Equity Group and Young Worker Self-Identification

PSAC members who belong to the following groups are invited to self-identify. This information is required should you wish to participate in caucuses and elections. There will not be an opportunity to self-identify during the virtual Convention.  This information is kept confidential and will be used for the purposes of supporting our equity initiatives and programs. Please check all that apply.

PSAC Equity Contact Lists

(This information is kept confidential.) Please note that this information may be shared with different structures of the union in support of our human rights work only.

Accommodation of a Disability

The PSAC strives to ensure that PSAC events are barrier-free for our members with disabilities. Once selected, members may be required to further specify their accommodation needs in order to facilitate their participation at the virtual Convention. A separate form may be sent to selected participants who have identified as members with disabilities requiring accommodation.

(You may be required to provide relevant medical documentation that will assist us to respond to your request.)

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 http://psacunion.ca/family-care-policy.

 

Thank you for completing the registration form.