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Proxy Registration Student Information
 

Summary: Proxy Registration
Student Information
Last or Family Name First Name Middle Initial Home Phone
Current Mailing Address Business Phone
City or Town Province Postal Code University of Regina E-mail Address:
Students who wish another person to register them or make changes to their registration must provide their proxy with
written signed permission to act on their behalf.
I hereby give __________________________________________ permission to register me for courses in the following
semester(s):
I authorize do not authorize the above named to have access to the information in my student records required
to complete my registration.
I understand that I am responsible for reviewing the details of my registration to ensure they are correct
(www.uregina.ca/webservicesforstudents , login to yoUR Self-Service), for the payment of all tuition and other fees that
result from my registration, and for notifying the University in writing if I should decide not to attend.
______________________________________________________ ________________________
Signature Date
Proxy Registration
Student Information
Last or Family Name First Name Middle Initial Home Phone
Current Mailing Address Business Phone

  

Source: Argerami, Martin - Department of Mathematics and Statistics, University of Regina

 

Collections: Mathematics