Letter/form Request - Algoma University
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1LETTER/FORM REQUEST
OFFICE OF THE REGISTRAR
A. Personal Information
First Name:
____
Last Name :
___________________
Student Number:
Email Address:
_____
Mailing Address: _______________________________________________________________________________
Home Telephone Number:
Cell Phone Number(optional) :
___________
B. Letter Form Request
Please choose ONE of the following($5.00)
☐ Verification letter of Graduation
☐ Confirmation of Enrollment
Bank/Insurance, Education Plan, Other ☐
Immigration and Study Permit Purposes ☐
Additional Letters Provided ($25.00)
☐ QECO letter
☐ Required program change (Please indicate your new intended program)
☐ Program/ Degree audit in a letter format (Required to extend scholarship)
☐Other (Please Specify)
** A minimum of five working days is required to process the request.
C. Delivery
☐ To be picked up from student registration
☐ To be email to:
☐ To be faxed to: (Fax number)
Addressed to:
☐ To be mailed to:
Student’s Signature:
Date:
Office Use Only
Payments Method: ☐MC
☐ Visa
☐ Amex
☐ DC
☐Cash
☐ Cheque
Date:
Amount:
Initial:
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