Consent for the disclosure of information

Your personal information is confidential and secure with us. By authorizing La Fondation de l'Université de Sherbrooke to make a withdrawal based on the above information, you are also consenting that the information on this form be disclosed to the financial institution, insofar as the information disclosed is directly related to this transaction. I attest that I have read and that I accept the conditions regarding changes, cancellation, and reimbursement, as stipulated in this authorization.

Changes, cancellation, or reimbursement

Please note that it is not our regular practice to make a reimbursement. We ask that you contact us regarding any questions, concerns, or need to discuss a reimbursement.

No form available.