400 UMSU University Centre
Winnipeg MB R3T 2N2 Canada
Tel: 204-474-9420
Fax: 204-269-1065
REQUEST FOR DOCUMENT SEARCH
This form is to be completed by undergraduate students requesting a document search of their Registrars Oce student le.
Masters and Ph.D. should contact their home department directly to request copies of their documents.
Students requesting documents that originate from within North America must contact the institution that the document came from.
ELC students should contact the English Language Centre directly to request a document search
The fee for each Document Search is $17.60 (may request multiple documents); if the requested document is not found, the fee is not refunded. All areas of this form must be completed.
Please allow approximately five working days for processing.
Last Name(s): Given Name (s):
Student Number:
Date of Birth:
Daytime Phone Number:
If you are resending this form to ensure it was received, please check here so that your request is not duplicated:
PICKUP METHOD:
Pick up
Letters not collected will be shredded three months after the original request date. Photo ID will be required upon pick up.
SHIPMENT METHOD:
Recipient Name:
Address:
City/Town:
Province/State/Region: Zip/Postal Code: Country:
Phone Number:
Please complete the Shipment Method section, above. Delivery problems arising from incorrect information being provided above are not the responsibility of the Registrar’s Oce.
PAYMENT INFORMATION:
Cash (payments are made in the Cashier’s Oce, 138 University Centre), open 8:30 am to 4:00 pm Interac/Debit
Cheque/Money Order (made out to ‘The University of Manitoba’) MasterCard or Visa (no other credit cards accepted)
Card holder’s name (as it appears on the card):
Amount: $
Applicant: Date: Card Holder:
(Signature) (Signature if not the applicant)
Credit card number: Expiry date:
(for mail-in only)
Notice Regarding Collection, Use, and Disclosure of Personal Information by the University
Your personal information is being collected under the authority of The University of Manitoba Act. The information you provide will be used by the University for the purpose of producing your Document Search request. Your personal information will not
be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of your personal information, contact the Access & Privacy Oce (tel. 204-474-
9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2.
Mail
Courier
(cannot courier to a PO BOX)
Additional courier fees will apply:
• $20.00 Anywhere in Winnipeg
• $50.00 Anywhere in Canada
• $50.00 Anywhere in U.S.A.
• $100.00 International/Overseas
Pick up by third party
:
(rst and last name of person authorized to collect the document)
DOCUMENT INFORMATION:
INSTITUTION NAME:
Document type (check one):
High School Transcript
University or College Transcripts from another University
Other: (specify the institution and type of document you are requesting):
Format Request:
Photocopy (one copy per requested document)
Original
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