Return Completed From Directly To The Department To Which You're Applying
Return Completed From Directly To The Department To Which You're Applying
(attach additional sheet if necessary) Language(s) other than English that you: Speak Read Write
(attach additional sheet if necessary) Names of faculty members of the University of Alberta with whom you have consulted or corresponded regarding admission:
Name of Referee
Academic Rank/Position
Email Address
Name of Referee
Academic Rank/Position
Email Address
Personal information on this form is collected under the authority of Section 33(c) of Albertas Freedom of Information and Protection of Privacy Act for authorized purposes including admission and registration; administration of records, scholarships and awards, student services; and university planning and research. Students personal information may be disclosed to academic and administrative units according to university policy, federal and provincial reporting requirements, data sharing agreements with student governance associations, and to contracted or public health care providers as required. For details on the use and disclosure of this information call the Faculty of Graduate Studies and Research at 492-3499 or see www.ualberta.ca/FOIPP. 03/2011