Academic Probation Letter Template Page 2
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2RYERSON UNIVERSITY
FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT
(FIPPA Statement)
This information is collected under the authority of the Ryerson University Act and is used by Ryerson University for the purposes of
determining your eligibility for financial assistance, including but not limited to financial awards, customer account refunds and
bursaries. The information collected may also be used on an aggregate basis in order to comply with Ryerson University’s statutory
reporting obligations. The information you provide will not be disclosed for any other purpose except for as stated herein unless
authorized and/or required by law. If you have questions about the collection, use, and disclosure of this information by Ryerson
University please contact Carole Scrase, Manager Student Financial Assistance/
In order to assess your eligibility for some forms of financial assistance, we may need to review your academic record.
By checking the box below, you hereby consent to the disclosure of your academic record by the Registrar to Financial Assistance for
the purpose of assessing your eligibility for student financial awards and/or assistance.
Please note that if you do not consent to the disclosure, we will not be able to determine your eligibility for some forms of financial
assistance.
NAME: __________________________________ STUDENT #: ________________________
(Please Print)
(Please Print)
FIPPA CONSENT (First statement must be checked off to have your income information updated)
I consent to the disclosure of my academic record by the Registrar to Financial Assistance for the purposes set out above.
I do not consent to the disclosure of my academic record by the Registrar to Financial Assistance for the purposes set out
above.
I understand I may not be eligible for some forms of financial assistance.
SIGNATURE: _____________________________________ DATE: _____________________
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Parent category: Letters