UBC E-Payment Forms Toonie LunchCertificate Program Application FeeCertificate Student Activity FeeKey DepositM.Eng Activity FeeMask FittingMining Alumni DinnerMining 4th Year TripMiscellaneous Undergraduate ExpensesMining GamesStudent Safety Training Toonie Lunch: Friday, Jan. 20, 12-1pm Name* First Last Email* Enter Email Confirm Email Student Number (enter 9999999 if you are not a student)* Student status (choose one)*1st year Engineering2nd, 3rd, or 4th year Mining EngineeringOther faculty/departmentOther universityMeal option (choose one)*Beef bento boxChicken bento boxTofu bento boxSalmon bento boxTotal $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. Additonal comments (e.g. dietary restrictions/allergies, etc.) PhoneThis field is for validation purposes and should be left unchanged. Certificate Program Application Fee Name (as it appears on application)* First Last Email* Enter Email Confirm Email Do you have a UBC Student Number?*YesNoStudent Number* Domestic or International Student*DomesticInternationalTotal $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted) If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. Total $ 0.00 CAD NameThis field is for validation purposes and should be left unchanged. Certificate Student Activity Fee Name* First Last Email* Enter Email Confirm Email Student Number* Certificate Student Activity Fee* Price: Total $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. PhoneThis field is for validation purposes and should be left unchanged. Key Deposit Name* First Last Email* Enter Email Confirm Email Student Number* Key Deposit* Price: Total $ 0.00 CAD In addition to the $50 key deposit, a Key Request Form will need to be completed, signed, and submitted to the administration office or info@mining.ubc.ca before keys will be issued. Key Request Form Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. EmailThis field is for validation purposes and should be left unchanged. M.Eng Activity Fee Name* First Last Email* Enter Email Confirm Email Student Number* Price* Total $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. EmailThis field is for validation purposes and should be left unchanged. Mask Fitting Name* First Last Email* Enter Email Confirm Email Student Number* Mask Fitting Fee* Price: Total $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. CommentsThis field is for validation purposes and should be left unchanged. Mining Alumni Dinner Name* First Last Email* Enter Email Confirm Email UBC Alumni: Graduation year (if applicable) Student Number (enter 9999999 if you are not a student)* Meal Options*BeefFishVegetarianName of Guest (enter N/A if no guest) Meal Options for Guest (choose none if no guest)NoneBeefFishVegetarianAdditional comments (i.e. dietary restrictions/allergies, accessibility requirements, etc.)Total $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. PhoneThis field is for validation purposes and should be left unchanged. Mining 4th Year Field Trip Mining 4th Year Field Trip Payment Form Name* First Last Email* Enter Email Confirm Email Student Number* Field Trip Fee* Price: Fee will be refunded upon meeting fundraising goalsTotal $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. PhoneThis field is for validation purposes and should be left unchanged. Mining Games Mining Games Name* First Last Email* Enter Email Confirm Email Student Number* Team Jacket Fee* Choose a Size*SMLXLTotal $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. PhoneThis field is for validation purposes and should be left unchanged. Mining Safety Training Name* First Last Email* Enter Email Confirm Email Student Number* Price* Total $ 0.00 CAD Payment accepted by credit card or Interac online (Visa Debit not accepted If applicable, remove any special characters from name fields with similar letters from the ISO basic Latin alphabet ISO basic Latin alphabet You will NOT be registered for the event until you have completed a successful payment Please retain a copy of the receipt after your successful transaction for your records. NO OTHER RECEIPTS WILL BE GENERATED. The charge will appear on your credit card statement as UBC ePayment 604-822-2008. NameThis field is for validation purposes and should be left unchanged.