Submit form to one ofMail Registrar Enrolment Services 100 West 49Avenue Vancouver BC V5Y2Z6Fax6043235590Emailgraduationevallangarabcca STUDENT146S SIGNATURE DATE ID: 392526
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OFFICE USE ONLY RECEIVED/PAID STAMP IMPORTANT INFORMATIONPlease read and abide by the following: Parchments are issued only in their original form. Copies are not available. Replacements for lost or damaged parchments will be Parchment Replacement Request Form REGISTRAR & ENROLMENT SERVICES STUDENT INFORMATION - to be completed by the studentLegal last or family name: Langara ID: Former last or family name: Legal rst or given name(s):Middle name(s): Postal code: Province: City: Country: Email: Primary telephone: Other telephone: DELIVERY METHODName of credential awarded: Year of graduation: Date of birth (YYYY/MM/DD): PROCESSING FEESFees in Canadian dollars and non-refundable. $38.00 Regular Studies ( ve business days processing) SUBMIT COMPLETE F (if applicable) CIRCUMSTANCES OF REQUEST Circumstances of request (No request for parchment replacement will be considered without explanation): RETURN OF DAMAGED PARCHMENT DECLARATION I will mail to Langara my damaged parchment: Registrar & Enrolment Services O ce, Langara College, 100 West 49 th Avenue, Vancouver, BC V5Y 2Z6. I will explain why my parchment is not available to return: By submi ing the information I have entered on this application, I certify that a) I am the person named in the “Student Information” section above, and b) the information I have submi ed is true, correct and complete.