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1. Personal Information



Salutation: *

2. Contact Information



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Number:*
Apartment Number:   Street Number:
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Street:*
Street Name: Street Type: Direction:
Ex. V8V 8V8

If you are an alumnus of The University of British Columbia (UBC), please provide the following information:

Degree:
Year of Graduation:

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4. Email and Mail Communication


Stay Up‐to‐Date

Would you like to stay informed about new courses, programs, special offers and events? Just tell us how you would like us to contact you. If you choose no, you will still receive communications relating to the administration of your UBC Extended Learning course or program.

Email: *
Mail: *

Privacy

We respect your privacy. Your contact information will not be released to others outside UBC.

Personal information provided on contact, subscription or registration forms is collected pursuant to section 26(c) of the Freedom of Information and Protection of Privacy Act (FIPPA), RSBC 1996, c.165, as amended. The information will be used for the purposes of: answering inquiries; admission; registration; academic progress; notification of future courses; and operating other UBC-related programs. UBC collects, uses, retains and discloses information in accordance with FIPPA. UBC may share and disclose personal information within the University to carry out its mandate and operations. Information, in aggregate form only, may also be used for research purposes and statistics.

Should you have any questions about the collection of information, please contact the Managing Director, Student Engagement and Marketing, UBC Extended Learning, 410-5950 University Boulevard, Vancouver, BC, V6T 1Z3.