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Student PEN Request Form

This document is a student PEN request form that collects personal information such as name, birthdate, gender, and school history to assign students a Personal Education Number (PEN). It instructs students to fill out the form and fax or email it to the provided contact information if they have not attended a BC K-12 school since 1993 or a public post-secondary institution since 1998. Upon completing their registration at a school, the institution will request the student's PEN on their behalf. The form collects additional information for mailing address and contact preferences to return the PEN assignment.

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Sunny Kumar
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2K views1 page

Student PEN Request Form

This document is a student PEN request form that collects personal information such as name, birthdate, gender, and school history to assign students a Personal Education Number (PEN). It instructs students to fill out the form and fax or email it to the provided contact information if they have not attended a BC K-12 school since 1993 or a public post-secondary institution since 1998. Upon completing their registration at a school, the institution will request the student's PEN on their behalf. The form collects additional information for mailing address and contact preferences to return the PEN assignment.

Uploaded by

Sunny Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Student PEN Request Form: The form is used to request a Personal Education Number (PEN) for students, providing fields for personal and educational information.

ATTN: PEN Coordinator

Data Management Unit


PO Box 9170 Stn Prov Gov
Victoria BC V8W 9H7

FAX: (250) 356-0277


NO COVER SHEET REQUIRED!

1701S

Student PEN Request Form


To obtain your Personal Education Number, please fill out the form below in FULL and fax (250) 356-0277 to the Ministry
or scan and email to PENS.Coordinator@gov.bc.ca. If you have not attended a BC K-12 School since 1993, written a
Provincial Exam since 1986, or attended a public post-secondary institution since 1998, you do not have a PEN, nor can
you be assigned a new PEN by submitting this form. Upon registration, the school you apply to will request a PEN on your
behalf.
Please note: Your PEN is not required for registration (electronic or otherwise), to any post-secondary institution. Not
having this number cannot deny or delay your registration in any manner.

I _______________________, hereby request my Personal Education Number.


(please sign your name)

Legal Surname

Legal First Given Name(s)

Legal Second (Middle) Given Name(s)

Usual Surname (if different)

Usual First Given Name (if different)

Usual Second (Middle) Given Name (if different)

Maiden Name (if applicable)

Past Name(s) (if applicable)

Birthdate

Gender

YYYY ____________ MM ______ DD _______


Last BC School Attended

Male _______

School Student ID Number (if known)


Female ________
Current School Attending (if applicable)

Please complete the following Ministry reply options to ensure the return of your
request
e-mail address: _________________________________________________________
fax number:

(__________)

PLEASE READ CAREFULLY AND INITIAL


THE PERSONAL DEMOGRAPHIC
INFORMATION PROVIDED ABOVE IS
COMPLETE AND ACCURATE.

____________________________________________

mailing address: __________________________________________


mailing address:

___________________
(Initials)

__________________________________________

City: ________________________

Province _____

Postal Code: _______________

Note: Usual surname and given name fields


are for use if you are known by a different
name than recorded on your birth certificate.

CONFIDENTIAL INFORMATION
The information collected on this form will be used to verify your identity for the purposes of communicating your personal education number to you, and
may also be used to update your PEN file. All information provided on this form will be administered in accordance with the Freedom of Information and
Protection of Privacy Act. For more information regarding the use of your personal information provided on this form, please contact the Student
Information Systems Branch, Data Management Unit, Ministry of Education.
N:\DataManagement\DM PEN\Forms\Student PEN Request Form.doc
Revised: 11/15/2016

Data Management Unit PO Box 9170 Stn Prov Gov Victoria BC V8W 9H7 ATTN: PEN Coordinator FAX: (250) 356-0277

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