CCOHS registration fee subsidy application

Error message

  • Notice: Undefined index: placeholder in mailchimp_signup_subscribe_form() (line 333 of /var/www/dev_psac_regional/profiles/re_psac_profile/modules/contrib/mailchimp/modules/mailchimp_signup/mailchimp_signup.module).
  • Notice: Undefined index: placeholder in mailchimp_signup_subscribe_form() (line 333 of /var/www/dev_psac_regional/profiles/re_psac_profile/modules/contrib/mailchimp/modules/mailchimp_signup/mailchimp_signup.module).
  • Notice: Undefined index: placeholder in mailchimp_signup_subscribe_form() (line 333 of /var/www/dev_psac_regional/profiles/re_psac_profile/modules/contrib/mailchimp/modules/mailchimp_signup/mailchimp_signup.module).
  • Notice: Undefined index: placeholder in mailchimp_signup_subscribe_form() (line 333 of /var/www/dev_psac_regional/profiles/re_psac_profile/modules/contrib/mailchimp/modules/mailchimp_signup/mailchimp_signup.module).
  • Notice: Undefined index: placeholder in mailchimp_signup_subscribe_form() (line 333 of /var/www/dev_psac_regional/profiles/re_psac_profile/modules/contrib/mailchimp/modules/mailchimp_signup/mailchimp_signup.module).
  • Notice: Undefined index: placeholder in mailchimp_signup_subscribe_form() (line 333 of /var/www/dev_psac_regional/profiles/re_psac_profile/modules/contrib/mailchimp/modules/mailchimp_signup/mailchimp_signup.module).
×

Please use this form to apply for a $600 subsidy to attend the Canadian Centre for Occupational Health and Safety Conference in Vancouver, February 29 to March 1 2016. This subsidy is designed to cover the registration fee for the Conference. Members are encouraged to approach their employer, Local and/or Components for assistance with any other costs, including travel, accommodation, and loss of salary that may be incurred.

Note fields marked * are required.

 

Personal information
Two questions
Optional Self ID
The PSAC is committed to ensuring that our education programs are accessible to all members. The information requested in this section will help us assess our success in reaching members who belong to groups identified in the PSAC Human Rights Policy. This information is voluntary and kept confidential and will be used for the purposes of supporting our equity initiatives and programs. Please check all that apply
Last Section!
Our Organization: