OFFICE OF THE UNIVERSITY REGISTRAR
Mailing Address: P.O. Box 1796 • Edmonton, Alberta, Canada T5J 2P2
Phone: 780-497-5000 • Toll Free: 1-888-497-4622
Website: www.MacEwan.ca • E-mail: info@macewan.ca
FREEDOM OF INFORMATION & PROTECTION OF PRIVACY
Protection of Privacy - The personal information requested on this form is collected and protected under the authority of Part 2 of the Alberta Freedom of Information and Protection of
Privacy Act and the Post-Secondary Learning Act. It will be used for the enrollment process and student management consistent with that purpose. This information will be entered into and
retained in the ocial university student information system database. Direct questions expressly related to the collection and use of this information to the Associate Registrar, Records,
Oce of the University Registrar, MacEwan University, 10700-104 Avenue, Edmonton, AB, T5J 4S2, telephone 780-633-3110.
EXCEPTION REQUEST FORM
OFFICE USE ONLY
STUDENT ID # NAME:
DECISION: __________________________________________________________________ FR:________________________________________________________________________________
PROCESSED: _______________________________________________________________ GR:________________________________________________________________________________
Phone: 780-497-5000 • Toll Free: 1-888-497-4622
PERSONAL INFORMATION COLLECTION NOTICE
The personal information requested on this form is collected under Section.33(c) of the Freedom of Information and Protection of Privacy Act for the purpose of one
or all of the following: to determine eligibility for admission and nancial assistance, to advise students about academic programs and to provide university services
at MacEwan University. Questions concerning this collection should be directed to the Lead, Privacy and Information Management at privacy@macewan.ca
Occasionally, students may experience circumstances which prevents their ability to meet published drop or withdrawal
deadlines. This form can be used to request exceptions to these deadlines. Requests submitted beyond one year of the
missed deadline will not be considered.
Check the appropriate category (A, B or C) which applies to your situation and submit this form along with the
required documentation listed below to the Office of the University Registrar. Only complete submissions
will be considered.
I have written and attached a letter/email that clearly outlines what action I am requesting on my
student record and specific details to justify my request.
A) My extenuating circumstance is medical in nature.
A significant medical condition occurred during the term. Minor illnesses will not qualify as an
extenuating circumstance.
I have attached a letter from the medical professional(s) who has been attending me,
substantiating the timelines surrounding my medical circumstance.
B) My extenuating circumstance is compassionate in nature.
Surrounding recent bereavement, serious illness within immediate family, or devastating situations
outside of the student’s control.
I have attached a copy of supporting documentation, one of:
medical documentation for the immediate family member
family member’s obituary or death certificate
other official documentation confirming devastating situation.
C) My situation is non-extenuating.
Situations other than those outlined above are considered non-extenuating. You may be eligible for a
one-time only adjustment on your student record. Revisions to your record will not be considered if a
previous exception has been granted during your time enrolled at MacEwan University.
This is my first request for an exception to the drop or withdrawal deadlines.
required
required
required
required
SIGNATURE:
DATE:
Support services available on campus:
Student Affairs
- 780-497-506
3
- studentaffairs@macewan.ca; SAMU Student Advocacy Office - savpacademic@macewan.ca -
780-497-5476.
Signature not required if sent from a student @mymacewan.ca email account
