Authorization for release of student information. · 2018-03-19 · post secondary education long...
1
Post Secondary Education LONG PLAIN FIRST NATION TREATY ONE 287(35) POST SECONDARY DEPARTMENT AUTHORIZATION FOR RELEASE OF STUDENT INFORMATION IMPORTANT - INCOMPLETE FORMS WILL BE RETURNED. PLEASE PROVIDE THE CORRECT USERCODE & PASSWORD. FAILURE TO DO SO WILL RESULT IN THE DISCONTINUATION OF FUNDING. PLEASE PRINT CLEARLY. DROP OFF OR MAIL THIS FORM TO THE ADDRESS BELOW. THIS OFFICE WILL ONLY ACCEPT THE ORIGINAL SIGNED COPIES. Post Secondary Institution: Name of Program Academic Year/Session: User Code: PIN: Date: DAY MONTH YYYY Student Name: Date: DAY MONTH YYYY DAY MONTH YYYY Expected Graduation (Date) Student Signature: Student ID#: PLEASE NOTIFY THE LPFN POST-SECONDARY PROGRAM IF YOU HAVE CHANGED YOUR PASSWORD. ONLINE ACCESS I hereby give permission to the above-named institution to release my sponsoring agencies any and all records that pertain to educational matter. Please send reports to the address in the box. LPFN Post-Secondary Department 110-5010 Crescent Road W. Keeshkeemaquah, MB R1N 4B1 “As long as the sun shines, the river flows and the grass grows...” LONG PLAIN FIRST NATION 110-5010 Crescent Road West, MB R1N 4B1 Phone: (204) 857-7474 Fax: (204) 857-7480 Email: [email protected] Website: www.lpet.ca
Transcript of Authorization for release of student information. · 2018-03-19 · post secondary education long...
Post SecondaryEducation
LONG PLAIN FIRST NATIONTREATY ONE 287(35)POST SECONDARY DEPARTMENT
AUTHORIZATION FOR RELEASE OF STUDENT INFORMATION
IMPORTANT - INCOMPLETE FORMS WILL BE RETURNED. PLEASE PROVIDE THE CORRECT USERCODE &PASSWORD. FAILURE TO DO SO WILL RESULT IN THE DISCONTINUATION OF FUNDING. PLEASE PRINTCLEARLY. DROP OFF OR MAIL THIS FORM TO THE ADDRESS BELOW.THIS OFFICE WILL ONLY ACCEPT THE ORIGINAL SIGNED COPIES.
Post Secondary Institution:
Name ofProgram
AcademicYear/Session:
User Code: PIN:
Date:DAY MONTH YYYY
Student Name:
Date:DAY MONTH YYYY DAY MONTH YYYYExpected Graduation
(Date)
Student Signature:
Student ID#:
PLEASE NOTIFY THE LPFN POST-SECONDARY PROGRAM IF YOU HAVE CHANGED YOUR PASSWORD.
ONLINE ACCESS
I hereby give permission to the above-named institution to release my sponsoring agencies any and all records that pertain to educational matter. Please send reports to the address in the box.
LPFN Post-Secondary Department110-5010 Crescent Road W.
Keeshkeemaquah, MBR1N 4B1
“As long as the sun shines, the river flows and the grass grows...”
LONG PLAIN FIRST NATION110-5010 Crescent Road West, MB R1N 4B1
Phone: (204) 857-7474
Fax: (204) 857-7480Email: [email protected]: www.lpet.ca
