Career Bridge Authorization Form

Authorization to reproduce physical likeness/voice/name/creative work For Educational, Marketing and Advertising Purposes.

All contact information (such as address, email and phone number) will be kept private and will not be published to the outside community.

Foip Statement

Protection of Privacy – If the information contained in the above authorization is personal information governed by the Alberta Freedom of Information and Protection of Privacy Act, such personal information on this form is collected under the authorization of Section 33(c) of that Act and is protected under Part 2 of that Act.

Such personal information will be used for the purpose of positive examples for other students for display on the University of Lethbridge website, for reference materials in lectures and for the purpose of managing the consent for disclosure of personal information process. Direct any questions about this collection to: Director, Governance (403) 329-2201.

This form will be retained and disposed of in accordance with approved records retention and disposal schedules of the University of Lethbridge.

Form Details

I hereby grant to the University of Lethbridge, including its employees, agents, assigns, or other third party as the University may authorize on its behalf, the nonexclusive right to:

Agreement *

Creative work
Combined audio-visual recordings of me, my voice, and/or my creative work

I authorize the University of Lethbridge to use designated creative materials for the purpose of positive examples for other students for the University of Lethbridge's programs, events and lectures.

Distribution will be made by/through the University of Lethbridge’s website, printed materials, and/or other electronic media in the period 2021 – 2029.

Contact Details

Full Name *

Email Address *

Are you: *

Alumni

Degree *

Student

Major: *

Current year of study: *

Submitting Project

When submitting your resume, replace all personal contact information with generic information. Example: (403) xxx-xxxx or (123) 456-7890, example@uleth.ca, and 123 street. Submissions will have contact information edited if not done.

Documentation 1: