Welcome to the Indigenous Student Centre for students at Western University. Please review the details of the
user agreement on our website before completing this form.
The personal information collected pursuant to this user agreement form is collected under the authority of the University of Western Ontario Act, 1982,
as amended, and will be used for the purpose(s) of granting after-hours access to the WSS building, and reporting and planning within Indigenous Student Centre at Western.
Please direct questions about this collection, use, or disclosure of personal information on this form to the Director, Indigenous Student Centre, (519) 661-4095.