Family Name As indicated in your Full Given Name As indicated in your
(In English) passport (In English) passport Date of Birth January 1, 2016 Gender Male Female Nationality Phone No. E-mail Mobile No. Current Address Theme Select one theme among the three themes Educational University __________________________________________________ Background Country _______________________ (Undergraduate) Major _________________________ Year _________________________ Educational University __________________________________________________ Background Country _______________________ (Graduate) Major _________________________ Year _________________________
I hereby declare that all information provided herein is true and correct.
Date: Name: (signature)
CONSENT FORM
1. Collection of your personal information
In due consideration of Article 15 of the Personal Information Protection Act of the Republic of Korea, the ASEAN-Korea Centre (hereinafter referred to as AKC) hereby requests your consent to collect and/or use your personal information. Type of information to be collected, collection method, purpose of collection/use, and the period of retention/use are as follows: A. Type of Information Collected and Collection Method - Application-related information: (English/Korean) name, date of birth, gender, address, nationality, email address, mobile number, name of school, major, country of school, date of (expected) graduation. - Collection Methods: documents submission B. Purpose of Collection/Use: application process C. Period of Retention/Use: prompt destruction 3 years after date of collection D. You have the right to withhold consent to the collection and/or use of your personal information. If you withhold consent, you may not proceed in the application process. 2. Privacy and Intellectual Property AKC reserves the right to utilize all data submitted by individuals to AKC without limitations. 3. Code of Conduct Applicants hereby certify that upon completion of the application process, all information submitted is truthful and accurate. Participants understand that falsification of any information provided will disqualify him or her from participation in the 1st ASEAN-Korea Academic Essay Contest (hereinafter referred to as the Contest), and falsification of information or impersonation will result in legal actions. Participants agree that all materials produced for the Contest will be original work. Plagiarism will not be tolerated by AKC, and should AKC discover instances of plagiarism, the individual will be disqualified from the Contest.
I hereby consent to the terms and conditions as specified above. (Yes, No)
Date: Name: (signature or seal)
Accepted and Acknowledged by the ASEAN-Korea Centre