Your name

NOTE: Names are requested for administration purposes only, your name will not be shared.
Your first and last name

Person who made a difference

College or unit

Activity or event

In the space provided below, please describe a specific act of support, encouragement or thoughtfulness that you appreciate and would like to acknowledge.

Notice Regarding Collection, Use, and Disclosure of Personal Information and Personal Health Information by the University

Your personal information and personal health information is being collected under the authority of The University of Manitoba Act. The information you provide will be used by the university to report and investigate an incident and for communication with you regarding the incident unless submitted anonymously. Your personal information and personal health information will not be used or disclosed for other purposes, unless permitted by The Personal Health Information Act (PHIA) or The Freedom of Information and Protection of Privacy Act (FIPPA).

If you have any questions about the collection of your personal information or personal health information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2.