Huron University Access/Correction Request

Huron University Access/Correction Request

Freedom of Information and Protection of Privacy
Request For:*
Select One
Faculty(ies)/Department(s) holding requested record(s):
Details*

PrefixFirst NameMiddle NameLast Name
Last name appearing on records (if different than above):
Name of Company or organization
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone

Area CodePhone Number
Alternate Phone

Area CodePhone Number
Detailed description of requested records, personal information records, or personal information to be corrected, including the time period of the records, if known. Please upload additional information as attachments if required.*
Please attach additional documentation if required:

Browse Files

Cancelof
If you are requesting access to, or correction of, your personal information, please identify the record, if known.

If you are requesting a correction of personal information, please indicate the desired correction and, if appropriate, attach any supporting documentation.

If you are requesting personal information on another person’s behalf, please attach proof that you have the authority to act for that person.
Preferred method of access to records*

Processing Fee*

Processing Fee

$5.00CAD

Total

$0.00CAD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Signature*

Clear
Today's Date

MonthDayYear
Today
Personal information contained on this form is collected pursuant to the Freedom of Information and Protection of Privacy Act and will be used for the purpose of responding to your request.

Questions about this collection should be directed via email to: privacy@huron.uwo.ca.
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