Fillable Student Personal Information (Please PRINT) This form is (Alberta Student Aid)

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Student Personal Information (Please PRINT) This form is (Alberta Student Aid)

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The Student Personal Information (Please PRINT) This form is (Alberta Student Aid) form is 1 page long and contains:

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  • 14 check-boxes
  • 21 other fields

Country of origin: CANADA
File type: PDF

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Request for Alberta Student Number (ASN)
August 2020
Page 1 of 1
This form is intended for adult students who are not enrolled in an Alberta K-12 school system.
Please select the reason for requesting an Alberta Student Number (ASN):
To register for Diploma Exam(s) To confirm your ASN (for students with multiple ASN’s)
To write the General Education Development (GED) Exams
Student Personal Information (Please PRINT)
Surname (Last Name)
First Name
Middle Name(s)
Previous Surname(s) (if applicable)
Previous First Name
Previous Middle Name
Gender
Male Female Unspecified
Email
Date of Birth (yyyy/mmm/dd)
Phone Number
Cell Number
Current Mailing Address
Alberta Student Number (if applicable)
City/Town
Province
Postal Code
The following information should be provided if applicable
City/Town
Last Grade Attended
A copy of one or more of the following documents MUST be provided to create your ASN
Please check the document(s) you are providing
Alberta/Canadian Birth Certificate
Canadian Citizenship Card
Alberta/Canadian Operator’s License
Canadian Permanent Resident Card
Alberta Identification Card/Canadian ID card
Canadian/Foreign Passport
Canadian Certificate of Indian Status
Other:
Student Authorization
I understand this request will be processed only if signed by myself (student)
You can use one of the following options to submit the signed and completed form:
Visit:
Or Mail:
Contact Information:
Online Document Submission
Alberta Education
Red Tape Reduction and Student Records
44 Capital Boulevard
10044-108 Street NW
Edmonton, Alberta T5J 5E6
Requests received via email will not be processed
Email:
Phone:
StudentRecords@gov.ab.ca
780 422-9337 (Dial 310-0000 to
be connected toll-free from
outside the Edmonton area)
Student’s Signature
Date
The personal information is collected pursuant to section 33(c), of the Freedom of Information and Protection of Privacy Act (RSA 2000, C. F-25). The
purpose of this collection is to enable Alberta Education to provide the correct Alberta Student Number to the student. Questions or inquiries regarding the
collection and use of your personal information may be directed to the Student Records Representative, Red Tape Reduction and Student Records, 44
Capital Boulevard, 10044 108 Street NW, Edmonton, Alberta T5J 5E6, or email to StudentRecords@gov.ab.ca or by telephone: 780-422-9337 (Dial 310-
0000 to be connected toll-free from outside the Edmonton area.)
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Student Personal Information (Please PRINT) This form is (Alberta Student Aid)

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Completed 2 January 2021

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