Fall School ONLINE APPLICATION Form

Call Out Letter

 

Fill in and submit ONLINE application below.  Please forward your completed Registration Form and $50.00 Registration Fee to:

Attn : Kellie Loshak

PSAC Kingston Regional Office

201 - 863 Princess Street, Kingston, ON  K7L 5N4

T:  613-542-7322 / F:  613-542-7387 / E:  loshakk@psac.com

Late registrations will not be accepted.

Information provided in the APPLICANT'S COMMENTS section of the Registration Form will be used in the selection process.

Registration Forms are due by - Monday, September 9, 2019.

 

Section 1 - Personal Information
What local are you from? Are you part of a component?
Section 2 - Course Selection
Check one course only
One only
Section 3 - Confidential Self Identification (optional)
The PSAC is committed to ensuring that PSAC Education Programs are accessible to ALL members. The information requested in this section will help us assess our success in reaching members who belong to groups identified in the PSAC Human Rights Policy.
Section 4 - Union activities
Section 5 - Union education
Location and year completed If not completed, date of registration
Location and year of each
Section 6 - Room Accommodations
This is an in-residence event. Accommodations are based on single occupancy. ALL ROOMS ARE NON-SMOKING – THERE ARE DESIGNATED SMOKING AREAS OUTSIDE
Section 7 - Travel Arrangements
Please indicate your mode of travel. Participants are expected to travel by the most direct, economical means.
Section 8 - Dietary Requirements
In the space below, please indicate if you have any special dietary requirements. Please be as specific as possible to assist the facility meeting your needs.
Section 9 - Access Information
The PSAC Accommodation Policy strives to ensure that union activities are barrier-free for participants with different abilities. Upon acceptance to the School, registrants may be required to further specify their accommodation requests to facilitate their participation in the School. Please be as specific as possible to assist the organizers and the facility in meeting your needs. Please Note: 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. Please check those that are applicable to you. Also provide specific details in the comments section below.
Section 10 - Family Care
Please note that on-site family care will not be provided at this event. To improve access to training for members with family care responsibilities, the PSAC Family Care Policy will apply. Please visit our website to review family care entitlements under the policy: http://psacunion.ca/family-care-policy
Section 11 - Environment
SMOKE FREE: All PSAC events, including this event, are smoke free. All meeting rooms and guest rooms are non-smoking. There are designated smoking areas outside the facility SCENT FREE: To assist members with environmental sensitivities, all PSAC events are scent-free events. SPECIAL NEEDS – ACCESS AND DIETARY REQUIREMENTS: The PSAC is committed to ensuring that the accessibility and dietary requirements of its members are respected. Please indicate any special needs; and provide any necessary explanation that will assist us in meeting those needs. The PSAC will take the necessary action to ensure the availability of transportation, equipment and/or people required to enable all members to attend and fully participant at this event.
Section 12 - Harassment Free
All PSAC events are harassment free. We can neither condone nor tolerate behavior which undermines the full and equal participation of all participants in all union activities.
Section 13 - PSAC Contact List Consent
I hereby consent to have my name and email address(es) added to one or more of the PSAC contact lists. Please note that this information may be shared with different structures within the PSAC only.
APPLICANT SIGNATURE and COMMITMENT

Applicant:  With this registration, I agree to attend and participate in all course sessions, including scheduled evening sessions, and to complete all assignments for the School. I have read the PSAC policy documents on human rights and harassment, and I understand my responsibilities in accordance with them.  

NOTE:  
Applicants should speak to their Local/Component to seek funding for the registration fee.

I will send in the signed registration form and $50 registration before the September 9th deadline.

Recommendation from Submitting Body
List the name, title and email of one of the following: PSAC Local President; Chair of Human Rights Committee; Chair of a Regional Womens’ Committee; Chair of a Young Workers Committee; President of an Area Council.
APPLICANT'S COMMENTS
Our Organization: