2026 PSAC Brandon Mobilization Summit – “Organize For Success” – IN PERSON and VIRTUAL

This 1 day training is open to Local leaders who have been identified and invited to attend. This event will provide Local leaders with an overview of the current state of Treasury Board bargaining and familiarize members with the roles and responsibilities around mobilization. Locals will engage in a membership mapping exercise to identify where members work, obtain up to date contact information and practice having important one on one conversations with members. Locals will have an opportunity to devise a communication/mobilization plan and connect with other Locals in the area to collaborate on multi-local events and actions throughout the province.

Name *

First

Last

Preferred Pronoun (She/He/They/Other) - Optional

PSAC ID

Local number

Component or DCL

Home Email *

Cell Phone *

Please include area code

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

______________________________________________________________________________________________________________________________________________________________________

Bargaining group

• PA
• SV
• TC
• EB

Will you be attending in-person or virtually?

• In-person
• Virtually

Do you require Loss of Salary? *

• Yes
• No

If yes, please indicate the date(s) and start/end times of your shift(s) in the next box below.

Shift Schedule (for eg. Friday, yy/mm/dd from 8 am to 4 pm, 9 am to 5 pm, etc) *

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.

Do you require Family Care? *

• Yes
• No

Family Care will be in accordance with the PSAC Family Care Policy (https://prairies.psac.com/family-care/). For any questions, please contact winnipeg-registration@psac-afpc.com

Do you require travel and/or accommodation? *

• Yes
• No

Travel arrangements will be in accordance with the PSAC Travel Policy (https://psacunion.ca/travel-policy). Approved participants will be contacted individually regarding travel arrangements. For any questions, please contact winnipeg-registration@psac-afpc.com

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 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 - 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.

Emergency Contact Information (The information you provide here is confidential and will only be used in the case of an emergency situation) *

First

Last

Emergency Contact's relationship to member *

Emergency Contact's phone number *

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