Consent for Disclosure of Personal Information


Consent for Disclosure of Personal Information 

Beal University Canada (BUC) collects personal information on students for the purposes of admission, registration, enrolment, surveys and other program-related activities. BUC then uses this information in the administration and operation of its programs and support services including lab work and practicum. In accordance with The Personal Information Protection and Electronic Documents Act (PIPEDA). BUC will disclose your personal information only on the basis of this consent. 

Exception: BUC may disclose your personal information without your consent where permitted or required by law or legal processes. 

Definition: Personal information may include some or all of name, student ID#, gender, date of birth, email, telephone number, program of study, location of study, and certification. 

Student name:  

Student ID#:   

Program of study:  

I authorize BUC to disclose the following information: 

Parents, guardians, other – Write the names of your parents or guardians:   

Student association (for services offered to the student community, e.g. BUC Student Council, if applicable)

External (non-BUC) sponsoring agency (for audit or verification purposes, e.g. Clinical Placement Site”) financial information 

Bursary/scholarship selection committees / donors (for the purpose of assessing eligibility) 

Potential employers (for employment, coop or practicum purposes, e.g. Horizon Health Network) 

Accrediting or other professional certification organizations (for accreditation, certification, membership, or employment purposes)  

BUC alumni association (for membership, development and offering of affinity programs)    

Graduation Ceremony 

------------------------------------------------------------------------------------------------------------------------------- 

PERIOD OF CONSENT: Consent shall be effective immediately. With the exception of BUC alumni association, consent will end five (5) years after completing your studies. You may withdraw your consent for any of the above (including BUC alumni association and Graduation Ceremony) by contacting BUC via telephone: (800) 660-7351 or email: registrar@bealuniversity.ca 

SIGNATURE: By signing this form, I authorize the disclosure of personal information as indicated above. I understand that I am not required to provide this consent and that consent may be withdrawn at any time. 

Contact BUC via telephone: (800) 660-7351 or email: registrar@bealuniversity.ca 

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Consent for Disclosure of Personal Information
lock iconUnique Document ID: a69fe2c59d03c0475a2af7ab7fdf2be978be38fb
Timestamp Audit
July 18, 2024 3:46 pm ESTConsent for Disclosure of Personal Information Uploaded by Sheree Rice - administrator@bealuniuversity.ca IP 71.255.159.238
July 22, 2024 10:31 am ESTRegistrar Department - registrar@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
August 12, 2024 4:26 pm ESTRegistrar Department - registrar@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
August 12, 2024 4:26 pm ESTFinancial Aid - FA@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
August 19, 2024 8:44 am ESTRegistrar Department - registrar@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
August 19, 2024 8:44 am ESTFinancial Aid - FA@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
August 19, 2024 8:45 am ESTRegistrar Department - registrar@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
August 19, 2024 8:45 am ESTFinancial Aid - FA@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 71.255.159.238
Audit trial Qr code
This audit trail report provides a detailed record of the online activity and events recorded for this document.
https://bealdocs.ca/
Audit Trail Serial# df406d99cd7c4a3cb2b428133c14d149