ASR-121B_V8 (2020:07)
IMPORTANT INFORMATION
Allow approximately six weeks for processing. Students that wish to attend convocation are to submit this form six weeks prior to the graduation date.
Visit bcit.ca/convocation.
To be eligible to receive your credential or attend convocation, all outstanding coursework must be completed and all outstanding financial obligations to
the Institute must be resolved.
Convocation is open to graduates of programs with a minimum of 45.0 credits or programs at an advanced level beyond a diploma.
Fields marked with an asterisk (*) are mandatory.
PERSONAL INFORMATION
Your BCIT ID Number*
A0
Legal First Name (given name)* Legal Last Name (family name)* Birth Date (DD-MMM-YYYY)*
CONTACT INFORMATION Please provide at least one phone number*
Mailing Address (number and street)* Home Phone Number
City* Province Postal Code* Mobile Phone Number
Country* Email Address*
PROGRAM INFORMATION
Program Name* Attendance*
Full-time
Part-time
Program Option (if applicable) Credential* (e.g, certificate)
CONVOCATION ATTENDANCE
1. Please choose one of the following
options.
I would like to attend June Convocation. I understand that it may be virtual or in-person and I must have
completed my final course and submitted this application by the first week of May.
I would like to attend February Convocation. I understand it may be virtual or in-person and I must have
completed my final course and submitted this application by the last week of December.
I will not be attending Convocation.
2. Return form to Student Records
at BCIT.
By mail: Student Records, BCIT, SW1-First Floor, 3700 Willingdon Ave., Burnaby, BC, V5G 3H2
By email: records@bcit.ca
3. Receive attendance confirmation. Visit your myBCIT account two weeks prior to Convocation for your attendance confirmation email. If you have not
received your confirmation email, please contact Student Records.
COLLECTION AND USE OF PERSONAL INFORMATION
BCIT collects personal information on this form for the purposes of confirming eligibility for a credential, administering the Convocation ceremonies,
determining any financial obligations, and other purposes relating to program completion and convocation. The information is also used to facilitate alumni
surveys and research and to conduct fund raising appeals. BCIT may also use student names and photographic images in communication materials for the
purpose of announcing and publicizing student and graduate achievements in new releases and internal communications.
Signature* Date (DD-MMM-YYYY)*
OFFICE USE ONLY
Program approved by: Date (DD-MMM-YYYY)
IWR # 24748; 27483; 821 Date Feb. 21/07; Oct. 17/07; Dec. 9/08
Contact Marcie Cvjetkovic; lori davis Local 8895
Filename forms/ASR-121.indd Bleed size n/a
Flat size same Created at (%) 100
Finished size 8.5 x 11 Output at (%) 100
Print type (offset/digital) RISO Stock white bond
Colours Black Production notes padded in 50s
Outside vendor (if applicable) OWNER STUDENT RECORDS
APPLICATION FOR BCIT CREDENTIAL
Student Records
SW1–1
st
Floor, 3700 Willingdon Avenue, Burnaby, BC, Canada V5G 3H2
T 604.432.8353 E records@bcit.ca
Instructions: 1) Save this PDF to your desktop, 2) Open with Adobe Reader or Adobe Acrobat, 3) Complete all required fields,
4) Save, 5) Close PDF then re-open to ensure the content you filled in has saved, 6) Submit to BCIT.
*Convocation 2021 pending review
click to sign
signature
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