PETL Service PIN Application & Award Dinner RSVP

Date: Thursday, April 24th, 2025

Registration will close on Friday, April 4th and payment (if applicable is due by 4:00 PM on Friday, April 4)

Time: 5:00 PM – 9:00 PM

Location: Mississauga Grand Banquet & Event Centre (35 Brunel Road, Mississauga, ON, L4Z 3W8)

TICKETS

Pin Recipients – Complimentary (NO Complimentary Guest)

PETL Honorary Life Membership Nominee, PETL Human Rights Award Nominee or Ted Wilkinson Steward Award Nominee – Complimentary (1 Guest Complimentary)

PETL Members $20

Non-PETL Members $40

Upon completion of the form below you will be redirected to the PETL Shop to complete your payment (if applicable).

Please email the Special Events and Awards Chair, Mitzy Alarcon, if you have any questions at events@etfopeel.com.

PIN & Awards Dinner RSPV (Please complete all relevant fields below)

First Name

Last Name

Full Home Mailing Address

Non-Board Email

Name as you’d like it to appear on the certificate

Home / Mobile Phone Number

Your School / Worksite

Please indicate the number of years you have been in the teaching profession, in any board, including part-time and occasional teaching.  Pins will ONLY be awarded to members whose years of service MATCH one of the designated years below.  They are not given retroactively.

2024-2025 is my 5th year of teaching 2024-2025 is my 10th year of teaching 2024-2025 is my 15th year of teaching 2024-2025 is my 20th year of teaching 2024-2025 is my 25th year of teaching 2024-2025 is my 30th year of teaching 2024-2025 is my 35th year of teaching 2024-2025 is my 40th year of teaching 2024-2025 is my 45th year of teaching 2024-2025 is my 50th year of teaching N/A – Attending Dinner but not a PIN recipient

Awards Celebration & Dinner RSVP

Yes I will attend the Awards Celebration Dinner and complete the requested information below No I will not attend the Awards Celebration Dinner and understand my PIN and Certificate will be sent in the courier to my work location

Ticket Type

Non-PETL Member $40 PETL Committee Member (Complimentary) PETL Executive (Complimentary) PETL Executive Guest (Union Affiliate – Complimentary) PETL Member $20 Pin Recipient (Complimentary – No Free Guest) Steward/Alternate (Complimentary) STPDL Committee Chair (Complimentary) Honorary Life Membership Nominee (Complimentary) Honorary Life PETL Member (Complimentary) Ted Wilkinson Steward Award Nominee (Complimentary) PETL Human Rights Award Nominee (Complimentary) N/A Not Attending The Dinner

Number of Complimentary Tickets

Number of Tickets Requiring Payment

Total Number of All Tickets

Total Amount Payable (If $0 type $0 – zero)

Seating Preference (You and Guest if applicable)

Click Here to SelectAnywhere/No PreferenceWith Colleagues (Listed Below)With my Committee members

Further Seating Details If Required (i.e., Names of Colleagues, Guest,)

Acknowledgements

If payment is required I will ensure it is received at the PETL Office (either online or by courier) by the deadline If I pay by cheque/cash I will clearly write "Awards Dinner Tickets for NAME" on the envelope/cheque N/A Not Attending the Dinner

Dietary Requirements Including Those for Guest If Applicable (Type N/A if not attending the dinner)

Accommodations Including Those for Guest If Applicable Dietary Requirements Including Those for Guest If Applicable (Type N/A if not attending the dinner)

Self Identification

Non-Binary Woman Man 2 Spirit LGBTQIA+ Heterosexual Non-Disabled Person with a Disability First Nations Metis Inuit Black White Racialized Person (specify below)*

Racialized Person (Please Specify)

Submit

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