BCIT / BCGEU OHS Rep Expression of Interest

Thank you for stepping up to be an OHS rep and for taking the time to complete this survey! The information you provide will assist us to appoint BCGEU members to ten new JOHS committees being established at BCIT’s Burnaby Campus.

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* 1. Name (first and last)

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* 2. Your bargaining unit:

BCIT Support Staff

BCIT Instructors

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* 3. Which committee(s) are you looking to join:

Burnaby Campus JOHSC

Facilities and Campus Development

Corporate Services

School of Business & Media

School of Computing and Academic

School of Health Sciences

School of Transportation

School of Construction and Environment

School of Energy

Student Services & Registrar's Office

Library, ITS, HR, Learning & Teaching Centre

Other (please specify)

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* 4. In order to appoint you to your new JOHS committee, and to make sure you receive information and updates from the BCGEU, we need to make sure we can connect with you. Please provide the following contact information:

Personal/ home email:

Home phone:

Home address:

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* 5. What is your interest in becoming an OHS rep?

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* 6. Supervisor Information

Supervisor Name

Supervisor Email