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AMAPCEO Health & Safety Representative Application

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If you are interested in becoming a health and safety representative and/or an AMAPCEO representative on a local Joint Health and Safety Committee (JHSC), use this form to submit your application. For more information on the responsibilities involved, read our frequently asked questions (FAQs) on the Role of Health and Safety Representatives.  

To complete this form, you will be asked to provide: 

  • Your workplace information 
  • Any health and safety training or credentials received to date 

Eligibility: To be eligible for appointment as an AMAPCEO health and safety representative, you must be (a) a signed member in good standing, i.e., have signed an AMAPCEO membership form, (b) hold a home position in an AMAPCEO bargaining unit and (c) not be currently acting in or seconded to a position outside an AMAPCEO bargaining unit (e.g., in OPSEU or management-excluded). The information provided in this form will be sent to the appropriate District Director for review before being submitted for approval to the AMAPCEO Board’s Health, Safety and Wellness Committee.