U-Pass Re-issue Request

Please complete this form if you need your U-Pass re-issued due to issues, device changes, etc.

Name Name First Last
Student Number
Must be 9 digits. Currently Entered: 0 digits.
Ontario Tech Email Address
Reason for Request

Reason for Request Device change Uninstalled/reinstalled app Phone reset Invalid ticket Other (Please specify) Other (Please specify)
Additional Notes

If you'd like to expand on the reason for having your U-Pass re-issued, please explain it here.
Make/model of new device
Disclaimer

Personal information on this form is collected under the authority of the University of Ontario Institute of Technology Act, SO 2002, c. 8, Sch. O. and will be collected, protected, used, disclosed and retained in compliance with Ontario’s Freedom of Information and Protection of Privacy Act R.S.O. 1990, c. F.31. This information will be used for education, administrative and statistical purposes and to administer registration within the university. Questions regarding the collection of your personal information may be directed to the Registrar, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, 905.721.3190, email: connect@ontariotechu.ca.

If you require this information in an alternative format due to disability, please email connect@ontariotechu.ca.