Create New Account Complete the four-part form below, that's it! Required fields are marked with an asterisk (*) 1. Personal Information Salutation: * Dr. Miss Mr. Mrs. Ms. Mx. Professor First Name: * Middle Name: Last Name: * Birth Date: * SIN: The Canada Revenue Agency requires your SIN be included on T2202 Tuition and Enrolment Certificates for eligible courses and programs. In order to be able to issue your T2202 form when it becomes available in February, please provide your SIN. 2. 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Street Address: * Number:* Apartment Number: Street Number: - Street:* Street Name: Street Type: Direction: Avenue (English) Alley Boulevard (English) Crescent Drive Lane Place (English) Road Street Terrace Way Abbey Acres Allée Autoroute Avenue (French) Bay Beach Bend Boulevard (French) By-pass Byway Campus Cape Carré Carrefour Centre (English) Centre (French) Cercle Chase Chemin Circle Circuit Close Common Concession Corners Côte Cour Cours Court Cove Croissant Crossing Cul-de-sac Dale Dell Diversion Downs Échangeur End Esplanade Estates Expressway Extension Farm Field Forest Freeway Front Gardens Gate Glade Glen Green Grounds Grove Harbour Heath Heights Highlands Highway Hill Hollow Île Impasse Inlet Island Key Knoll Landing Limits Line Link Lookout Loop Mall Manor Maze Meadow Mews Montée Moor Mount Mountain Orchard Parade Parc Park Parkway Passage Path Pathway Pines Place (French) Plateau Plaza Point Pointe Port Private Promenade Quai Quay Ramp Rang Range Ridge Rise Rond-point Route Row Rue Ruelle Run Sentier Square Subdivision Terrasse Thicket Towers Townline Trail Turnabout Vale Via View Village Villas Vista Voie Walk Wharf Wood Wynd N NE E SE S SW W NW City: * Postal Code: * Ex. 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Create Your Password Password: * Confirm: * 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: * Please select your answer Yes, I would like to receive this information via email. No, don’t send me this information via email. Mail: * Please select your answer Yes, I would like to receive this information via mail. No, don’t send me this information via 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 Director, Marketing, UBC Extended Learning, 410-5950 University Boulevard, Vancouver, BC, V6T 1Z3.