Privacy Notice

We are collecting your personal information under the authority of the Colleges Act (RSA 2000, Chapter F-25) which mandates the provision of programs and services. We ask for this information to determine your eligibility for training and applicable services, and for research and statistical purposes. If you have any questions about the collection, use and/or disclosure of this information, you may contact the Registrar's Office at (780) 623-5580.

* indicates a required field

First Name*
Middle Name
Last Name*
Select a Username*
Select a Password*
Confirm Password*
Mailing Address*
Mailing Address (Line 2)
City*
Province*
Postal Code*	-
Email*
Telephone*	() - Ext Type (Select One)
Profession*	Other (Specify)
Health Region*	Other (Specify)

Consent To Release Information

I authorize Portage College to disclose relevant personal information about me collected on this form, as required:

To its contracted agents or societies for the purpose of confirming my enrollment status and to determine my eligibility for contracted services.
To Alberta Learning to maintain enrollment and statistical reporting , and to obtain my statement of marks or student identification number.

I hereby consent to the above conditions* Yes No