Consent to Release Information
STUDENT INFORMATION
BVC Number: _______________ OR Alberta Student Number (ASN): _______________
(six-digit #) (nine-digit #)
Legal Name: __________________________________________________________________________
(Appearing on Government Identification: passport, driver’s license, etc.)
APPLICATION INFORMATION
Program Name: ________________________________________________________________________
Program Start Month: Program Start Year:
CONSENT TO RELEASE INFORMATION
I hereby authorize Bow Valley College to receive, request, and share information regarding my
application with the individual or organization indicated below:
AGENT / REPRESENTATIVE INFORMATION
Name: _______________________________________________________________________________
(Full name of agency, relative, friend, or other representative)
Email: _____________________________________ Phone: _______________________________
(Email and Phone not required for Authorized Agents with signed agreements)
My consent is given for the purpose of facilitating my application to and enrolment with Bow Valley
College. This consent will be valid for one calendar year from the date below or until I provide written
notice of withdrawn consent.
I understand that all such information will be treated as confidential by the agent or representative and
Bow Valley College.
Student Signature: __________________________________ Date: ___________________________
Questions? Contact the International Education Department at 345-6 Ave SE, Calgary, Alberta, T2G 4V1
Email: international@bowvalleycollege.ca Phone +1-403-410-3476
Version Updated 02.2019
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