Office of the Registrar
Regional Office
11401 - 8th Street
Dawson Creek, BC
V1G 4G2
Ph: 250-782-5251
Fax: 250-782-5233
Toll Free: 1-866-463-6652
Personal Information
Last Name Student ID Number
Full Given First Name Social Insurance Number
Middle Name(s)
The student shall notify the College in writing of any changes and become
familiar with current withdrawl and refund policies.
Changes to Personal Data
Name Home Phone
Mailing Address Business Phone
City Current Email Address
Province
Postal Code
Signature of Student
Please print form and sign by hand
Signature of Registrar
Student Record Update
CONFIDENTIAL
CAMPUS OF STUDIES
Chetwynd Dawson Creek Fort Nelson Fort St. John Tumbler Ridge
189a/14.02.17-j