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PSAC Edmonton Committee AGM’s, Thursday, February 9th, 2023
5:30 pm - 8:00 pm
10665 Jasper Ave, Suite 670, Edmonton
Facilitator: Carm Chan
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Name
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Last
PSAC ID
Component
Personal Email
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Personal Phone Number
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Please include area code
Is the above Personal Phone Number a cell number?
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Cell Number
Address
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Address Line 1
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I will be attending the following meetings:
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Regional Women's Committee @ 5:30 pm
Human Rights Committee @ 6:15 pm
Edmonton Area Council @ 7:00 pm
Please select all that apply.
DIETARY NEEDS : light snacks will be provided, please let us know if you have any dietary restrictions by February 6th.
ACCESSIBILITY REQUIREMENTS FORM - Do you have a disability or disabilities?
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Yes
No
The PSAC is committed to accessibility and therefore we ask that you complete this form if necessary so that the PSAC can ensure your full participation at PSAC events. The form is confidential and the information provided will not be disclosed except where necessary to respond to your request for accommodation.
If yes to the above question, what are the functional limitations and restrictions arising from your disability or disabilities? (you do not need to disclose your diagnosis)
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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