PUBLIC SERVICE ALLIANCE OF CANADA ALLIANCE DE LA FONCTION PUBLIQUE DU CANADA Application for Membership, Replacement, Info, Update Demande D'adhesion, Replacement de Carte, Mise-A-Jour PSAC ID Employee ID Number Member Details / Coordonnees Du Membre Mr/MMs/Mme Surname First Name Address City Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Northwest Territories Nunavut Yukon Postal Code Phone Email Language Preference EnglishFrench Employment Information / Information Sur L'Employee Division FBIT- Faculty of Business and Information Technology FED - Faculty of Education FEAS - Faculty of Engineering and Applied Science FESNS - Faculty of Energy Systems and Nuclear Science FHS - Faculty of Health Sciences FS - Faculty of Science FSSH- Faculty of Social Sciences and Humanities Work Site North Downtown Whitby Other Date Hired Classification Sessional TA/RA or Invig PDF Action Requested / Action Demandee Action Application for membership and PSAC ID CardID Card ReplacementAll Other Changes Date Signature [ please sign in black or blue ink ]
