FITA application form

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).

  • Name * Required
  • Local address * Required
  • Date Format: YYYY slash MM slash DD
  • MondayTuesdayWednesdayThursdayFriday 
  • (with whom; how is the atmosphere; how long does it take to get to campus?)
  • How committed to the FITA program do you think you will be? * Required
    On a scale of 1 to 5.