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Safety Concern Form

Safety Concern Form

The University of Regina collects information under the authority of The University of Regina Act and in accordance with the Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act for purposes of the administration of the University and its programs and services. By responding to this form, you are consenting to the University of Regina using your personal information (to/for ...describe specific purpose of information gathering on this form).

First Name * Last Name * Email Address * Re-enter your email address * Subject * Safety Concern Message *