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Information Release Form

This document is an information release form used by Ambrose University College. It allows students to consent to having specific information released to individuals or organizations. The form collects the student's contact information and details of what information they agree to release such as confirmation of enrollment, transcripts, or degree completion. The student must also provide contact information for where the information should be sent. Once completed, the form is returned to the registrar's office at Ambrose University College.

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53 views1 page

Information Release Form

This document is an information release form used by Ambrose University College. It allows students to consent to having specific information released to individuals or organizations. The form collects the student's contact information and details of what information they agree to release such as confirmation of enrollment, transcripts, or degree completion. The student must also provide contact information for where the information should be sent. Once completed, the form is returned to the registrar's office at Ambrose University College.

Uploaded by

aschlamp
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Information Release Form

Please note: Information will not be released for any student with an unpaid account.
Name Street Address Email Student ID City Telephone ( Date of Birth Prov Fax ) ( ) Postal Code

I consent to the release of:

Confirmation of enrolment letter International worker letter Unofficial transcript Letter confirming completion of all program requirements Degree Audit Copy of the attached form once completed Other:_____________________________________________________________________________

To the following individual and/or organization:


Name/Organization Street Address Email

City

Check here if same as above

Prov Fax ) (

Postal Code

Telephone (

To be:

Picked up

Mailed

Faxed

Emailed

Student Signature: _____________________________________

Date: _____________________

Privacy Statement: This form gives Ambrose University College permission to release the specific information requested by the student. Ambrose University College cannot be held responsible for how this information is used, disclosed, or protected by the designated recipient. If you have any questions about the Personal Information Protection Act (Alberta) and Ambrose University Colleges Privacy Policy contact the Privacy Compliance Officer at privacy@ambrose.edu Return this form to the Office of the Registrar, Ambrose University College 150 Ambrose Circle SW Calgary AB T3H 0L5 Fax: 403.571.2556 Email: registrar@ambrose.edu
Office Use Only: Prepared By: ____________________ Date sent: ______________________ Method Sent: _______________________________ Entered in Actions: _______________________
Revised: Nov 2010

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