Request Information

Tell us about yourself

First Name

Last Name

Birth Date

I am a(n):

Do you wish to declare that you are an Indigenous person?YesNo

Email Address

Confirm Email Address

Communication Consent

I consent to receive information about my scholarship application status, important deadlines, and other important ULethbridge information. (Please note, if you do not check this box you will not receive confirmation of your SFAD appointment.)

Where are you from?

This is an in-person experience. Participants wanting to sign-up for Student-For-A-Day must be residing in Canada and be able to visit Lethbridge.

Country

City

Postal Code / Zip Code

Address (e.g. Street; P.O. Box)

Emergency Contact Info

Emergency Contact Name

Emergency Contact Number

Schedule and Program Choice

Each program has a designated day for Student for a Day, based on mentor availability. Please select your preferred program from the list below.

Please refer to the mentor profile page to learn more about each mentors and what program they specializes in!

Preferred Program (1st Choice)

Preferred Program (2nd Choice)

You may choose a second option in case your first choice of program isn’t available on its scheduled day.

Do you have mobility and/or other special physical requirements?YesNo

Educational Interests

I am:

What Faculty are you interested in?

What are you interested in?

Program of Interest

Location

Intended University Start Date (Term & Year)

Are you currently enrolled in High School?YesNo

Indemnification & Release of Liability

In return for allowing me to voluntarily participate in the program and all related activities, I agree: (1) TO ASSUME AND ACCEPT ALL and ANY RISKS arising out of, associated with or related to my participation in the SFAD program and all related activities (2) TO BE SOLELY RESPONSIBLE FOR ANY and ALL INJURY, LOSS OR DAMAGE which I might sustain while participating in THE UNIVERSITY OF LETHBRIDGE (3) TO HOLD HARMLESS AND THE UNIVERSITY OF LETHBRIDGE from any and all liability for any damage to the personal property of, or personal injury to, any third party resulting from my participation in the SFAD program and all related activities; (4) TO HOLD HARMLESS, INDEMNIFY AND THE UNIVERSITY OF LETHBRIDGE, their officers, directors, agents, volunteers, employees and representatives from liability for any and all claims, demands, actions and costs which might arise out of my participation in SFAD program and all related activities.

Code of Conduct

The University of Lethbridge Student For A Day Program entails visiting the university campus for a day of activities, eating a meal provided by the university, attending lectures and participating in related activities as determined by the organizers: (1) I agree not to bring or consume any alcohol or illegal substances for the duration of this event (2) I will behave responsibly and appropriately and adhere to any rules of conduct laid down by the organizers of this visit.

Signature (Parent/Guardian or Participant, if 18+)

If you are under the age of 18, you must have a parent/ guardian sign below on your behalf to participate in the SFAD program.

PRIVACY STATEMENT - The personal information collected on this form is used to send you educational and informational materials and to create records to facilitate follow-up contact with you on your decision to attend a post-secondary institution. It will also be used for internal statistical and enrolment management purposes. This collection is authorized by section 4(c) of the Alberta Protection of Privacy Act (POPA). The University of Lethbridge uses automated systems to generate content and make decisions, recommendations and predictions. The personal information collected may be included in these automated systems. For questions about the collection of personal information, contact the Privacy Officer, University of Lethbridge, 4401 University Drive West, Lethbridge, Alberta, T1K 3M4, privacy@uleth.ca, or 403-332-4620