In The Maer of a Request to Enrolment Services for a Replacement Of Credential
I, _______________________________________________________________________________________________________________________________
(Full Legal Name)
of ______________________________________________________ in the Province of ______________________________________________________
(City/Town) (Province)
Do solemnly declare that:
I was awarded the Credential of ___________________________________________________________________________________________________
in the year _____________ by Thompson Rivers University.
The original Credential was:
Not picked up
Lost
Destroyed
Due to the following circumstances (aach a page if necessary): ______________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
I MAKE THIS SOLEMN DECLARATION conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath.
Signature of Declarant: _________________________________________________________ Date Declared: _________________________________
Declaration of Loss
Original Credential
Enrolment Services
805 TRU Way
Kamlooops, BC V2C 0C8
Phone: 250-828-5036
admissions@tru.ca
tru.ca
MC123078
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