OFFICE OF THE UNIVERSITY REGISTRAR
P.O. Box 1796 • Edmonton, Alberta, Canada T5J 2P2
Phone: 780-497-5000 • Toll Free: 1-888-497-4622
www.MacEwan.ca • E-mail: recordsunit@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.
PERSONAL INFORMATION
PROCESSING INSTRUCTIONS
AUTHORIZATION OFFICE USE ONLY
MAILING/PICK UP INSTRUCTIONS
PLEASE FILL IN ALL INFORMATION IN FULL (PLEASE PRINT)
(CHOOSE ONLY ONE “PROCESS” OPTION PER FORM)
STUDENT ID NO.:
PROGRAM CURRENTLY ENROLED IN (OR RELATED TO THIS REQUEST)
FAMILY (LAST) NAME: FIRST NAME: MIDDLE NAME:
FORMER NAME(S) (IF APPLICABLE)
ADDRESS: CITY/PROVINCE: POSTAL CODE:
BIRTH DATE:
MM __________ DD __________ YY___________
HOME PH.: CELL:
ENROLMENT VERIFICATION
I AUTHORIZE MACEWAN UNIVERSITY TO RELEASE THE LETTER REQUESTED.
SIGNATURE: _________________________________________________________
DATE: _______________________________________________________________
ENTERED BY: _____________________________________________________________________________
DATE: ____________________________________________________________________________________
SENT BY: ________________________________________________________________________________
DATE SENT: _______________________________________________________________________________
MAIL TO MY HOME ADDRESS (As listed above)
MAIL TO ALTERNATE ADDRESSES
__________ 1.NAME:
# OF COPIES
ADDRESS:
CITY/PROVINCE:
POSTAL CODE:
GENERAL REQUEST FORM
Requests will be processed within 5 business days.
Phone: 780-497-5000 • Fax: 780-497-5001
__________ 1.NAME:
# OF COPIES
ADDRESS:
CITY/PROVINCE:
POSTAL CODE:
WILL PICK UP AT: (Photo Identication is required at the time of pickup)
Office of the University Registrar (Building 7, 7-110)
SCE Student Support Centre (Allard Hall 11-521)
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
TOTAL NUMBER OF LETTERS
REQUESTED: ______________
Signature not required if sent from a student @mymacewan.ca email account
NOTE: this form is not required for
general enrolment and credential
verifications. These documents
can be downloaded and printed
via myStudentSystem. Instructions
are available on MacEwan.ca.
COURSES EXTRA TO CREDENTIAL (Attestation Letter)
VISA RENEWAL
CO-OP WORK PERMIT (submit request to MacEwan International)
POST GRADUATE WORK PERMIT (submit request to MacEwan International)
OTHER (Please State)
