AI registration Form

PERSONAL INFORMATION

Name *

First name *

PSAC ID *

Name of your Component or Directly Chartered Local (DCL) *

For example: SEI 10007 or SLCD 10333

Name of your bargaining unit *

For example: PA, CRA, Parks, Postdocs, Research and Teaching Assistant

Personal email *

Mobile phone *

Adress *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

EMERGENCY CONTACT

Full name *

Family relationship *

Phone number *

INFORMATION ABOUT THE TOUR

I register as a person: *

representative of a local section of a Component
representative of a DCL
representing an executive of a district
representative of the Quebec Council
leader of a Component

For Component local representatives and SCLD representatives, please first confirm your interest with your local executive before registering. Please note that the expenses of a Component leader are not covered by the AI Tour funds. The lunch meal will be offered free of charge.

I will need a union release letter for this activity: *

I will participate for the first time in a union activity organized by PSAC: *

INFORMATION ON AI

The questions in this block will allow us to better adapt the presentations and workshops during the Tour.

Do you use an application derived from AI as part of your work? If so, which one(s)? *

If you believe you are not using an AI-derived application, please indicate: I don’t know.

What is (or could be) useful for AI in your work? *

If you do not know, please indicate: I do not know.

What effects of AI do you notice in your work? *

If you do not know, please indicate: I do not know.

What are the questions you ask yourself regarding AI? *

If you have no questions, please indicate: none.

TRANSPORTATION

I will travel to the event as follows: *

By public transportation
By car
By plane and I will have to rent myself a car to get from the airport to the event venue
Other

PSAC will prioritize the least expensive means of transportation, although the vast majority of members will use their car to get to the event as close as possible to their workplace. If you need to use the plane to get close to the event venue, please let us know and we will contact you to make arrangements for booking your flight ticket. If you have another need, please let us know and we will communicate with you.

ACCOMMODATION

I need a hotel room: *

One bed
Two beds
No room required

Preferences will be granted according to availability. Note that the PSAC travel policy applies and members who live within 100 km of the meeting location are not entitled to a hotel room.

I will need an on-site family daycare service: *

If yes, for how many children and their age?

SELF-IDENTIFICATION

Your self-identification status will be treated confidentially.

I agree that PSAC-Quebec use the information provided in the self-identification section for the purposes of the AI tour:

This question is to obtain your consent to use your self-identification only for statistical purposes.

If you identify as a young activist, what is your year of birth?

This question aims to better identify your belonging to young activists than for statistical purposes.

ACCEESSIBILITY REQUIREMENTS

PSAC is committed to ensuring accessibility. Therefore, we ask you to fill out this form if necessary so that PSAC can ensure your full participation in this event. The form is confidential and the information provided will not be disclosed, unless it is necessary to respond to your accommodation request.

Do you have one or more disabilities?

You do not need to disclose your diagnosis.

If yes, what are the functional limitations and restrictions arising from your disability(s)?

I need PSAC to make arrangements for a personal care attendant to assist me so that I can attend the event.
I need documentation in an alternative medium.
I need printed documentation.
I need a sound amplifier.
I need a sign language interpreter.
I need PSAC to make arrangements for a reader to assist me so that I can participate in the event.
I will use an assistance animal (ex. un guide-chien) during the event.

Please indicate any other needs to take into account your functional limitations and restrictions., including food restriction or allergy. *

You may be asked to provide relevant medical documents that will help us respond to your requests.

AUTHORIZATION FOR TAKING PHOTOS

Do you authorize PSAC to take photos of you during the event and make them public on our platforms? *