Solidarity in Action – Convention Delegate Late Registration / Alternate Registration

Personal Information

PSAC ID *

Component your arising

Registration *

I would like to register as a delegate

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. PSAC has worked to create a more sustainable Convention to reduce our carbon footprint. Our actions have included reducing the amount of paper and materials distributed, and recycling and reusing Convention materials. Of note – printed copies of convention materials will only be provided to attendees who request them at the time of registration.

Climate change

I require a printed copy of the convention materials.

Delegate Profile

Participant Options

I am a first-time delegate to a regional convention.

Orientation session

I will be attending the Orientation Session on the Rules of Order.

What delegate seat do you hold? *

First name *

Last name *

Preferred name

What are your pronouns?

(eg: he/him, she/her, they/them)

Preferred language of communication *

Mailing address *

City *

Province *

Postal Code *

Work phone

Home phone

Mobile phone

Preferred personal email address *

(provide the address you would like used for correspondence for this convention – cannot be an employer email)

Component or Directly Chartered Local *

Local number

Local name

Region

Texts

I authorize PSAC to send me conference information via text (SMS) messages to my mobile phone for this event

Loss of salary and expenses

Actual loss of salary will be reimbursed for working hours lost during the Convention. There will be no compensation of salary for weekends except for delegates who are regularly scheduled to work on a Saturday or a Sunday upon receipt of official work or shift schedule. There will be no overtime compensation.

Please identify if you will require loss of salary to be covered.

If you require loss of salary for Saturday or Sunday, please indicate below.

I will require an advance for expenses associated with this event. *

Advances will be provided at registration

Will you be claiming loss of salary OR leave with pay as specified by your collective agreement? *

I will require a union leave with pay letter for this event. *

No scents please

In consideration for the health of our members who may suffer from environmental disabilities, and with the goal of eliminating a contaminant from the air, the PSAC requests that all participants attending the convention refrain from using scented products. These include scented perfumes, colognes, lotions, hairsprays, deodorants and other products promoted by the fragrance industry.

Emergency Contact

Name *

Relationship to the Participant *

e.g. spouse, parent, friend, etc.

Phone *

Equity Declaration Form

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. 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

Equity contact list

Please add my name and contact information to one or more of our respective PSAC Equity, Young Workers, and Francophone 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

PSAC strives to ensure that PSAC events are barrier-free for delegates with disabilities. Once selected, delegates may be required to further specify their accommodation needs in order to facilitate their participation at the Convention.

Disability

I am a member with a disability and require accommodation.

What are the functional limitations arising from your disability?

(You are not obliged to disclose your diagnosis, only your functional limitations.)

Disability Options

I require that the PSAC arrange a personal care attendant to assist me in order for me to fully participate at Convention.
I require documentation in alternative media.
I require sound amplification.
I require a sign language interpreter.
I require an oral interpreter.
I require that the PSAC arrange for a Reader to assist me in order for me to fully participate at Convention.
I will be using animal assistance (i.e. guide dog).

Hotel Accommodation

The PSAC has reserved a block of rooms for delegates. All room reservations will be made by PSAC Atlantic. We will follow up with hotel confirmation once booked. All hotels are unionized and accessible.

Hotel option

I require specific accommodation for my disability in my hotel room.

Please specify

Dietary Restrictions or Allergies

Diet option

I have dietary requirements or allergies.