Individual Information Release for Academic Success Centre

The University of Alberta Academic Success Centre collects and protects personal information under the authority of the Alberta Freedom of Information and Protection of Privacy Act for the purposes of operating its programs and services. 

The Academic Success Centre Release of Information Request form may be used to request the disclosure of information regarding your use of our programs and services to another person, designated agent or agency, or legal counsel, or for other purposes, including

  • confirmation of attendance at or completion of Academic Success Centre services.
  • completion of a form from another U of A department or non-U of A organization.
  • verbal communication or consultation with another U of A department or non-U of A organization.
  • provision of your own verification of disability or accommodation paperwork.

Please review the instructions below carefully in order to ensure that you have all information required to complete the form successfully. 

Requests must be received at least seven (7) working days prior to the date by when the information is required. Incomplete information may delay the processing of your request.

Information Required to Complete the Form

To request the release of information about your use of Academic Success Centre services, you will need to provide:

  • your personal information (name, student status, U of A CCID if applicable, U of A ID if applicable, telephone, email).
  • the services about which you want information released (type, date or dates, advisor if applicable, workshop/course title, if applicable).
  • information about the person to whom the information is to be released (name, title, department, organization, address [including city, province, country, postal code], telephone, email).
  • method of information release (direct communication or letter by email).
  • the date by when the information release is required.
  • any additional information relevant to your request.
Important Information to Note
  • One (1) form must be completed for each request.
  • Requests must be received at least seven (7) working days prior to the date by when the information is required.
  • Confirmation of attendance letters are not released directly to students. They are emailed to staff within your faculty or department and copied to you. If you do not know the contact details for the individual who requires confirmation of your attendance, please consult your faculty or department before completing this form.
  • If you require information to be released to one office about more than one service in a given academic term, please complete one (1) form for all of the services.
  • If you are registered for academic accommodations and require a copy of any previously submitted documents, Disability or accommodation paperwork cannot be released via email. It must be retrieved in person from our office in 1-80 Students' Union Building or faxed to you. 
  • We are only able to confirm information about or completion of University of Alberta Academic Success Centre services. We cannot advocate on behalf of students in situations related to the Code of Student Behavior, and are not able to provide
    • academic references for program or scholarship applications.
    • assessments of students’ suitability for academic programs or employment.
    • confirmation of accommodations used at other educational institutions.
    • employment references.
    • students’ verification of disability documentation directly to other parties. 
  • Due to the restrictions enacted by the Government of Alberta regarding the COVID-19 pandemic, documents may not currently be retrieved from our office in person.  
 Questions? Please contact us at success@ualberta.ca.
Audience

Students

Category
Academic Support
Provider
Provost