FITA application form

NOTE: Please give 3 different possible appointment times between 9am and 3pm, Monday to Friday. We are closed evenings.

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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, and in accordance with the Freedom of Information and Protection of Privacy Act (FIPPA) for the administration of the University and its programs and services. Direct any questions about this collection to Student Wellness and Accessibility Services (905-688-5550 x5188).