75th ORC - Photo/Video Release Form
I hereby DENY my permission for images taken of myself during PIPSC meetings such as Regional Councils or Steward Councils, through video or digital mediums.
Name of Member (please print):
Please fax your completed form to the PIPSC Toronto office, attention Heather Kohli at 1.800.281.7280 or 416.487.7268.
*Please note: all information contained in this form will remain confidential.