Published on Brock University (http://brocku.ca)

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Student Life

Name: *

Email Address: *

Faculty & Program: *

Year of Study: *

Tell us about the "other side of your brain" and how it relates to your Brock experience

Respond here : *

This will appear on your online profile. (Max. 1 paragraph or approx. 250 words)

Provide an image of yourself for use on your profile

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Provide a striking image that is representative of the "other side of your brain"

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Collection Notice

Brock University protects your privacy and your personal information. The personal information requested on this form is collected under the authority of The Brock University Act, 1964 [1], and in accordance with the Freedom of Information and Protection of Privacy Act (FIPPA) [2] for the administration of the University and its programs and services. Direct any questions about this collection to Student Life [3] at studentlife@brocku.ca [3]

Source URL: http://brocku.ca/student-life/brock-people/student-leader-profiles/submit-your-profile