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I n compliance with the Freedom of Information (College of the Rockies)

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Country of origin: CANADA
File type: PDF

Canada forms for College of the Rockies

BROWSE COLLEGE OF THE ROCKIES FORMS

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Enrolment Services
2700 College Way, Box 8500
Cranbrook, BC | V1C 5L7
250-489-8237 | 250-489-8219 Fax
1-877-489-2687 x 3237 Toll Free
Scan and email to: reghelp@cotr.bc.ca
7/19/2019\jkH:\REGISTRA\forms\Student Information Release Authorization [2019].docx
Student Information Release Authorization
I
n compliance with the Freedom of Information and Protection of Privacy (FOIPOP), the College of the Rockies (COTR) is
generally prohibited from providing certain information from your student records to a third party, such as information
on grades, invoices, financial aid (including scholarships, grants, or loan amounts) and other student record information.
This restriction applies, but is not limited to, your parents (under certain circumstances), your spouse, or a sponsor. It
may be important for these individuals to be able to access such information, especially if they play a key role in financing
your education.
Y
ou may, at your discretion, grant the College permission to release information about your student record to a third party
by submitting a completed Student Information Release Authorization form to the Registrar’s Office. The specified
information will be made available only if requested by the authorized third party. The College does not automatically
send this information to the third party. Authentication of the caller will be required before release of this information
by telephone.
S
ubmit your completed form to the COTR Registrar’s Office at the address given above. Please note that your
authorization to release information has no expiration date; however, you may revoke your authorization at any time by
submitting this request to the Registrar’s Office.
STUDENT INFORMATION
Student Number
First Name
Last Name
AUTHORIZATION
Please check one or more of the boxes below to grant authorization of information specified:
Grades/GPA, personal information, enrolment, academic progress status and other information
related to academics
I
nvoices, charges, credits, payments, past due accounts, and/or collection activity
Financial aid awards, application data, disbursements, eligibility and/or financial aid satisfactory
academic progress status, College-maintained loan disbursements and loan repayment history
T
uition, Education, and Textbook Amounts Certificate (T2202A form)
I WISH TO REVOKE my authorization to release information to the designate mentioned below
AUTHORIZED DESIGNATE(S)
Name of Designate (first, middle initial, last)
Relationship to student
APPROVAL LENGTH
From:
To:
Enrolment Services
2700 College Way, Box 8500
Cranbrook, BC | V1C 5L7
250-489-8237 | 250-489-8219 Fax
1-877-489-2687 x 3237 Toll Free
Scan and email to: reghelp@cotr.bc.ca
7/19/2019\jkH:\REGISTRA\forms\Student Information Release Authorization [2019].docx
AUTHENTICATION QUESTIONS AND ANSWERS
To ensure security of your student record, please have your designate** (e.g. parent or spouse) provide two security
questions and answers. This information will be kept on your file and COTR staff will only provide information you
have agreed to release to the person who can provide the answers to those questions.
Question 1:
Answer 1:
Question 2:
Answer 2:
**Sponsors are required to relay the details of the sponsorship and the name of a contact person.
DECLARATION
Freedom of Information/Protection of Privacy
The College of the Rockies complies with the Freedom of Information/Protection of Privacy legislation of the Province of British Columbia. Information
collected on this form is used in the normal course of College operations in accordance with this legislation.
Please read the following before signing:
I declare that the information contained in this form is to the best of my knowledge, complete and correct. I hereby agree to comply with the rules and
regulations of the College.
CERTIFICATION
I acknowledge that this authorization starts as of the date this form is signed and has no expiration date, however, I can
revoke the authorization at any time by submitting a written request to the Registrar’s Office. By signing this form, I
authorize the College of the Rockies to release the information specified to the person(s) listed above. The purpose of
this authorization is to assist the person(s) in supporting me (financially or otherwise) in connection with my College of
the Rockies education.
____
____________________________________ ______________________________________
Student’s Signature Date
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Completed 5 February 2021

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