Steward Application Form

Home Mailing Address
Work Address (actual physical address)
Give 3 to 4 names of colleagues that support your nomination.
If you were elected as a Steward, please state the date and place of the Election.
Conflict with your Employer
(Grievance, harassment, tension, difficult communications)
I agree to serve and promote the Institute and its members to the best of my abilities, with honesty and integrity and to advance the values and mission of the Institute. I have read and understood the Guidelines for the appointment of new Stewards. I also agree to undertake PIPSC Basic Steward Training at the earliest possible opportunity.