PSAC Self-Identification Questionnaire

Completion of this questionnaire is voluntary, but by doing so you are helping to establish baseline data about the composition of the BC region's membership. This information will not be shared with sources outside the PSAC.





For equity purposes, 'persons with disabilities' means persons who have long-term or recurring physical, mental, sensory, psychiatric or learning impairment and consider themselves to be disadvantaged by reason of that impairment.
1. Are you a person with a disability?
Please check all boxes that apply

An Aboriginal person is a North American Indian or a member of a First Nation, a Metis or an Inuk. North American Indians or members of a First Nation include status, treaty, or registered Indians as well as non-status and non-registered Indians.
2. Are you an Aboriginal person?
Please check the appropriate box
A person is racially visible in Canada, other than an Aboriginal person, who is non-white in colour or race, regardless of place of birth.
3. Are you racially visible?
Please check all boxes that apply

4. Are you a member from the Gay, Lesbian, Transgendered or Bisexual community?
Please check the appropriate box
5. Are you under 30 years of age?

6. Please indicate your gender:
7. Please check this box if the Public Service Alliance of Canada may use the information you have provided on this form for administrative purposes. This could include seeking your participation on advisory committees and your input on specific employment equity/diversity issues and participation in Equity/Diversity Committees, Conferences, and Conventions
Thank you for taking the time to complete this questionnaire. If you have any questions, please call us at (604) 430 0191 or toll-free at 1 (866) 811 7700