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VIERA Registration and Consent Form

Is the Course Date Known?

Consent to Release Information to Pro Board

I hereby consent to allowing VIERA - Vancouver Island Emergency Response Academy to release the following information to National Board on Fire Service Professional Qualifications - Pro Board for the purpose of being registered with the Pro Board Certification Registry:

Consent to the above statement

Consent to Release Information to Employer

I hereby consent to allowing VIERA - Vancouver Island Emergency Response Academy to release to my employer my test results, Statement or Certificate of Course Completion and verification of attendance in connection with this course. I understand that my consent is required prior to release of the specified information.

Consent to the above statement

Consent from My Employer

I have been directed by my Fire Chief or supervising Chief Officer to register for this course.  I understand that I can only register for VIERA courses if I have been given permission from my Chief Officer.

Consent to the above statement

Emergency Contact Information

 

 

IMPORTANT INFORMATION ABOUT PRIVACY AND YOUR PRESENTATION

  • Information collected on this form is done so under the general authority of the Community Charter and Freedom of Information and Privacy Protection Act (FOIPPA), and is protected in accordance with FOIPPA. Personal information will only be used by authorized staff to fulfill the purpose for which it was originally collected, or for a use consistent with that purpose.
  • Regular Council and Committee meetings that are open to the public are webcast using live-streaming video technology and may be recorded for video-on-demand access for subsequent viewing. By speaking at these meetings, you are consenting to disclosure of any personal information made evident through your speech or presentation materials, and acknowledging that this information may be disclosed and/or accessed outside of Canada. Personal information may include your image, name, address, and personal opinions. You are also asserting that your presentation is in compliance with the Federal Copyright Act, and grant the City of Nanaimo license to publish these materials. Individuals presenting to Council or Committees are requested to not disclose third-party information or it may be redacted.
For further information regarding the collection, use, or disclosure of personal information, please contact the Legislative Services Office at 250-755-4405 or at foi@nanaimo.ca. 


Last updated: April 4, 2025

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IMPORTANT INFORMATION ABOUT PRIVACY AND YOUR PRESENTATION

  • Information collected on this form is done so under the general authority of the Community Charter and Freedom of Information and Privacy Protection Act (FOIPPA), and is protected in accordance with FOIPPA. Personal information will only be used by authorized staff to fulfill the purpose for which it was originally collected, or for a use consistent with that purpose.
  • Regular Council and Committee meetings that are open to the public are webcast using live-streaming video technology and may be recorded for video-on-demand access for subsequent viewing. By speaking at these meetings, you are consenting to disclosure of any personal information made evident through your speech or presentation materials, and acknowledging that this information may be disclosed and/or accessed outside of Canada. Personal information may include your image, name, address, and personal opinions. You are also asserting that your presentation is in compliance with the Federal Copyright Act, and grant the City of Nanaimo license to publish these materials. Individuals presenting to Council or Committees are requested to not disclose third-party information or it may be redacted.
For further information regarding the collection, use, or disclosure of personal information, please contact the Legislative Services Office at 250-755-4405 or at foi@nanaimo.ca.