PLEASE NOTE! Persons under the age of 18 must provide the consent of a parent or legal guardian to take the telc examination.

First name/names*

Last name*

Name and surname of the legal guardian*

Date of birth (DD-MM-YYYY)*

Place of birth*

Nationality*

Gender*

Phone number*

E-mail address*

Home address (street, house number, flat number)*

Home address (city)*

Information clause*

I declare that I have read and accept the rules for conducting examinations by the Centre for Teaching Polish as a Foreign Language to Foreigners at Kazimierz Wielki University in Bydgoszcz. 1. Personal data controller The controller of your personal data is the Kazimierz Wielki University in Bydgoszcz. Contact: 1. by post to the following address: ul. Chodkiewicza 30, 85-064 Bydgoszcz. 2. by e-mail: cnjp@ukw.edu.pl 2. Data protection officer You can contact them in all matters relating to the processing of personal data and the exercise of rights related to data processing in the following ways: 1. by post to the following address: ul. Chodkiewicza 30, 85-064 Bydgoszcz. 2. by e-mail: iod@ukw.edu.pl 3. Purposes of processing and legal basis for processing Your personal data will be processed in connection with procedures related to recruitment for the exam. The legal basis for the processing of your personal data is Article 6(1)(a) of Regulation (EU) 2016/679 of the European Parliament and of the Council (EU) 2016/679 of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation): 1. Your consent to the processing of personal data for the purpose of proper registration of participants during the event to which this registration relates. Providing personal data is voluntary, but necessary to complete the registration process. If you do not provide your data, it will not be possible to achieve the above-mentioned purpose in the Registration System. 4. Period of storage of personal data. The data will be deleted after the end of the event to which the registration relates. 5. Data recipients We may transfer your personal data to public authorities or entities authorised to obtain data on the basis of applicable law. Your data will be processed by the telc Examination Centre in Rzeszów and transferred to entities cooperating with telc gGmbH Bad Homburg, Basler Straße 7, 61352 Bad Homburg, Germany. 6. Rights related to the processing of personal data and automated decision-making. You have the following rights related to the processing of personal data: the right to withdraw your consent to the processing of personal data at any time without affecting the lawfulness of the processing that was carried out on the basis of your consent prior to its withdrawal. Withdrawal of consent to the processing of personal data is tantamount to withdrawal from the registration procedure, the right to access personal data, the right to request rectification of personal data, the right to request erasure of personal data, the right to request restriction of processing of personal data, the right to object to the processing of data, the right to transfer personal data, the right not to be subject to automated decision-making, including profiling, the right to lodge a complaint with the supervisory authority responsible for personal data protection, i.e. the President of the Personal Data Protection Office. To the extent that your data is processed on the basis of consent, you have the right to withdraw your consent to the processing of your data at any time. Withdrawal of consent does not affect the lawfulness of processing based on your consent before its withdrawal. You may withdraw your consent by sending a statement to our postal address or e-mail: cnjp@ukw.edu.pl Statement of data accuracy I declare that the information provided and the certificates of its accuracy are true and accurate. I am aware that falsifying documents, certifying untruths, obtaining false certificates and using documents certifying untruths is subject to criminal liability (art. 270 – 273 ustawy z dnia 6 czerwca 1997 r. – Kodeks karny, Dz. U. Nr 88, poz. 553, z późn. zm.).

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