Student ID Order Form

Is this a replacement card?
I.e., you’ve been issued a card but it is lost or stolen.
- Yes
- No

Name*
First Last
Student Number*
Accept Replacement Charge*
- I agree and accept the replacement charge of $31.90. This charge will be added to your student account.
Address*
Shipping Address Additional Address Information (optional) City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Consent*
I certify that I am the named student on this request and am ordering this card for myself only and not on behalf of a third party.

I.D. card photo example.
Requirements for Student I.D. Card Photos
- • Photo must be current (taken within the last 3 months)
- • Photo must be in color
- • Photo should have a uniform light-colored background (a white background is preferable)
- • Front view of student’s face – head and shoulders only. The photo must show a full head without any head coverings unless it is worn for religious for medical reasons.
- • No sunglasses or hats.
- • The picture must be JPEG format with a file size less than 4 MB.
Please note we reserve the right to refuse any unacceptable photos. If the photo is deemed unusable, we will contact you to submit an appropriate photograph. All photos will be digitally stored for University use only.
Upload Photo*
The picture must be in JPEG format with a file size less than 4 MB.
Accepted file types: jpeg, jpg, Max. file size: 4 MB.

Review Your Information
Student Number: {Student Number:5}{Student Number:20}
Name: {Name (First):1.3} {Name (Last):1.6}{Name (First):26.3} {Name (Last):26.6}
Address:
{Address (Street Address):2.1}{Address (Street Address):23.1}
{Address (Address Line 2):2.2}
{Address (Address Line 2):23.2}
{Address (City):2.3}{Address (City):23.3}, {Address (State / Province):2.4}{Address (State / Province):23.4}, {Address (Country):2.6}{Address (Country):23.6} {Address (ZIP / Postal Code):2.5}{Address (ZIP / Postal Code):23.5}
Phone: {Phone:4}{Phone:25}
Email: {Email:3}{Email:27}
Accept Replacement Charge: {Accept Replacement Charge:22.1}
Consent: {Consent (Text):24.2}
Degree Category: {Degree Category:6}
Campus Attending: {Campus Attending:7}
Will you be living on campus during the 2021/22 academic year?: {Will you be living on campus during the 2021/22 academic year?:9}
Delivery or Pickup*
Delivery: Please allow 10-14 days for delivery. Pickup: Please allow a minimum of 5 business days for card processing. The Ancillary Services office is located on the main floor of McMaster Hall, accessible through the Darrach Hall link. You will need to show another form of Photo ID when you come to pick up.
- Please mail my Student ID card to the address shown on my application form
- Please hold my Student ID card for in person pickup at Ancillary Services
- I'm living in Residence (Student ID card will be waiting for you at time of check-In)
Digital Signature*
I certify that the information given by me is correct. In accepting the card and the associated facilities that I have requested, I agree to observe the conditions of use. I understand that the card is not transferable. I give my permission for the data provided on this student I.D. application form to be used for administrative purposes within Brandon University.
I agree to the above terms and conditions (checking this box constitutes digital signature)
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Comments
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Brandon University

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