Certificate Submission Form


Certificate of Insurance
Attach a physical copy of the certificate using the "Attachments" feature below.

NOTE: If your Insured Contact does not exist on the list you must select "Yes" under Add New Contact and submit the New Contact details below.


For questions about this form, please contact Philani Moyo
by phone at 416-979-5000 ext. 553772, or by email at philani.moyo@ryerson.ca


"YES" - My Insured Contact did not appear on the list and I need to add their information.

"NO" - I found the correct Insured Contact information on the list to the left.

New Contact Details

Please fill the following fields and submit to generate a new insured contact for your organization.








Enter the name located at the top of your certificate

Date that the insurance policy expires.
Select from calendar or use format: MM/DD/YYYY



Select from calendar or use format: MM/DD/YYYY


Student Insurance Submission

Attach a physical copy of the certificate using the "Attachments" feature below.

Note: When filling out the "Student Insurance Certificate Name" field, format using your name and building number (Ex. John Smith - 112A).


For questions about this form, please contact Philani Moyo
by phone at 416-979-5000 ext. 553772, or by email at philani.moyo@ryerson.ca


"Name - Building Name" - Ex. John Smith - BKS

Date that the insurance policy expires.
Select from calendar or use format: MM/DD/YYYY



Your Ryerson University Student Number





Canadian Policy Number

Attachments

Click "Submit" to finish your submission.