CRA Picket Line Strike Training for Local Executives (March 28, 2023)

In this one day in person session we will discuss and plan the operation of picket lines specifically for Treasury Board members. We will provide information on what a strike line looks like, signing in and out, and coordinating communication with members. We will focus on creating effective and safe strike activities including picket lines.

Name *

First

Last

How would you like to be identified (she/he/they)

PSAC ID

Component *

Local # *

Who do you work for? *

Home Email *

Home Phone *

Please include area code

Cell Phone

Please include area code

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

______________________________________________________________________________________________________________________________________________________________________

Do you require Loss of Salary? If yes, please indicate the date(s) and start/end times of your shift(s) in the next box below. *

• Yes
• No

Please note, that no member should be at a loss of salary for any courses taken. PSAC will cover salary for courses taken during your regular scheduled work hours. Our Finance department will require a copy of you shift schedule and a pay stub.

For any questions, please contact Shelley Jamieson at jamiess@psac-afpc.com for more information.

Do you require Family Care? *

• Yes
• No

For any questions, please contact Shelley Jamieson at jamiess@psac-afpc.com for more information.

Will you be traveling over 100kms for the event? *

• Yes
• No

If yes, please contact Shelley Jamieson at jamiess@psac-afpc.com for more information.

SPECIAL DIETARY REQUIREMENTS AND/OR ALLERGIES - Do you have any dietary requirements or any allergies that we should be aware of ? *

• Yes
• No

The PSAC is committed to ensuring that the accessibility and dietary requirements of our members are respected. Please indicate your needs in the box below and provide any necessary explanation that will assist us in meeting them (i.e. airborne, nuts etc)

ACCESSIBILITY REQUIREMENTS FORM - ACCESSIBILITY REQUIREMENTS FORM - Do you have a disability relevant to the course we need to address? *

• Yes
• No

The PSAC is committed to accessibility and therefore we ask that you explain any accessibility requirements below if necessary so that the PSAC can better accommodate you. The information collected below will be held confidential and will not be disclosed except where necessary to respond to your request for accommodation. Please list options for accommodating your functional limitations and restrictions in order to allow you to fully participate in the event. *

Other Comments: You may be required to provide relevant medical documentation that will assist us to respond to your request.

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