COURSE DESCRIPTION REQUEST FORM
Office of the Registrar
3377 Bayview Avenue, Toronto, ON M2M 3S4
Tel: 416.226.6620 ext.6711 Fax: 416.226.4210
Email: registration@tyndale.ca Webpage: www.tyndale.ca/registrar
Date of Request: ________________________**Normal processing time is 10 working days.
Last Name: ____________________________ First Name & Middle Initial:______________________________
Maiden or Other Name (if applicable): ___________________ Student I.D. (if known): _____________________
Current Address: ___________________________________________________________________________
Phone Number (Daytime): _________________________ Date of Birth(m/d/y): ________________________
Email: _________________________________ Student’s Signature: ________________________________
Please send the course descriptions listed below:
COURSE NAME YEAR
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
COURSE DESCRIPTION(S) TO BE:
Mailed to institution/organization at the address below
Mailed to student address
Picked up by student or by ______________ (specified)
Faxed/Emailed to: _________________ Attn:______________
NAME & ADDRESS OF INSTITUTION/ORGANIZATION:
Person/Department________________________________________
Institution _______________________________________________
Street___________________________________________________
City______________________ Province ______________________
Postal Code________________ Country______________________
FEE & PAYMENT:
$5 for 1 - 5 course(s)
$10 for 6 -10 courses
$15 for 11 – 15 courses
$20 for 16 – 20 courses
$30 for over 20 courses
Credit Card Cash Interac Money Order
! Personal cheques are not accepted.
VISA/MasterCard Debit cards can only be processed in person.
Credit card # and expiry date can be indicated below or left in our
password-protected message box at (416) 226-6620 ext. 2195.
- - - - - - - (This portion will be detached upon completion) - - - - - -
VISA/MasterCard Credit Card Number:
________ - __________ - __________ - __________
Expiry Date: _______ /_______ CVV: ________
Name on Card: ___________________________
Payment: $______ Received: ___________ Initial: ________
Sent: _____________________ Processed by: ____________
OFFICE OF THE REGISTRAR’S USE ONLY:
click to sign
signature
click to edit
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