Purchase Request: University Dining Plan 2024-2025 Contract Foip Statement Foip Information Protection of Privacy - The personal information requested on this form is collected under the authority of Section 33 (c) of the Alberta Freedom of Information and Protection of Privacy Act (“Act”) and will be protected under Part 2 of the Act. The information is collected for the purpose of purchasing a University of Lethbridge Dining Plan. If you have any inquiries in regards to the collection of your personal information, please direct those inquiries to: FOIP Coordinator, University of Lethbridge, 4401 University Dr. West, Lethbridge, Alberta T1K 3M4, telephone: 403-332-4620, email: foip@uleth.ca Registration Which dining plan are you looking to purchase? - Select -The Sampler Plan (Total Value: $2,250, Base Dollars: $0, Flex Dollars: $2,250)The Commuter Plan (Total Value: $4,600, Base Dollars: $3,900, Flex Dollars: $700)The Standard Plan (Total Value: $5,350 Base Dollars: $3,900, Flex Dollars: $1,450) All plan values listed are based on a September 2024 purchase date. Plans purchased after October 1st will be prorated based on date of purchase and dining plan selection. Are you a: Resident Non Resident Dining Plan Agreement: I have read, understood and acknowledge the Residence Dining Plan requirements for the plan I am selecting. I agree to receiving a DocuSign via Ulethbridge, Dining Plan and will ensure the information is correct, pay my deposit, sign it and submit it. You will receive a copy for your records once this is complete. Student Details Student Name: Student Email Address: Additional Questions or Comments:
