U Pass Opt-Out Form
**Le message en français sera au prochain écran**

Please complete this form in full. Any applications received with missing information will not be considered.

It is the student’s responsibility to ensure that the SGA/AGÉ is provided with all required supporting documentation. For further information please refer to the U-Pass section of our website at http://sga-age.com/u-pass/, email sga@laurentian.ca or call 705-675-1151 X 1094.

Please submit documentation proof required depending on opt out option on the form, in the upload section. All documentation must be uploaded in order to process your opt out request. PLEASE INCLUDE YOUR STUDENT NUMBER ON DOCUMENTATION.

You will be informed of a decision by electronic mail only. Please provide an up-to-date email address on the request form.

Refunds for successful opt-out requests will be available in the office late fall, 2018. Ownership of a vehicle does not grant eligibility for opt-out. Anyone who is caught providing false or misleading information will be banned from requesting an opt-out of the U-PASS for a period of 5 years.
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Thank you for your UPass opt out submission. Your application will be revised and your opt-out will be confirmed at the end of September.

Nous vous remercions pour votre soumission de demande de retrait du programme U-Pass. Votre demande sera traitée et votre renonciation sera confirmée dès une semaine de la date de soumission.
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