Application form
Field of study: ENGLISH
Application form should be completed in block letters in accordance with the data contained in the passport
I apply for admission to full time: Diploma studies / Bachelor’s studies / Master’s studies
PERSONAL DATA:
1. Surname …………………………................................................................................
2. Forenames ............................................................................………………………….
3. Othername ...........................................………………………………………………..
4. E-mail address…………………………………………………………………….……
5. Nationality ……………………………………….………….……..………….… …..
6. Passport series and number ……………………..………..….…………….…..……..
7. Country of issue of passport …………………………………………………..………
8. Information about Polish Citizenship Card Holder: YES / NO *
9. Date of birth (DD/MM/YYYY): ………………………...............................................
10. Mobile telephone numer ...............................................................................................
11. Address for correspondence: ………………………...…………………………..……
Other details of the address……………………………………………………………
Address :
…………………………………………………………………………………………………………………
………………………………………………………………………………………………………
Country …………………………….………
12. Gender: Female/ Male*
13. Place of birth: …….……Town ……..……Country………………………………..….
14. Home Address (permanent address) : Code…….….. Town………..………………..…
Other details of the address……………………………………………………………………………………
Country ……………………….……
15. Place of living before studies at HarooHA1: town / village*…………………………………….
*put X where appropriate
In accordance with art. 13 of the Directive of the European Parliament and Council (EU) 2016/679 of 27 April, 2016,
concerning the protection of natural persons regarding personal data processing and the free flow of such data as well as the
annullment of the directive 95/46/WE, we inform that:
1. The administrator of the processed personal data is: Academy of ENGLISH in Unit 101,Carvents House,Harrow
HA1 1PD,UK.
2. In all matters regarding the protection of personal data, you have the right to contact our Data Protection Officer at
the email address: iod@wstihuk .
3. The purpose of processing your personal data is to assess the qualifications for applying for admission to studies,
assess the abilities and skills needed to study a given field and the possibility of contacting the candidate regarding
current and / or future recruitment for studies.
4. Your personal data is processed on the basis of art. 6, paragraph 1, letter c) GDPR in connection with the Act of 20
July 2018 - Law on Higher Education and Science.
5. Your personal data will be stored for the time necessary to complete the recruitment process. After completing the
recruitment process, the candidate's documentation will be attached to the student's file.
6. The recipients of your personal data are entities authorized to disclose data to them under the law. Public authorities
that may receive personal data as part of a specific lawful procedure are not considered recipients. Personal data
may also be entrusted to entities that provide services to the Administrator (e.g. a debt collection company).
7. You have the right to: protect your personal data, request: access to it, obtain a copy, rectify, delete or limit their
processing, and the right to lodge a complaint with the President of the Office for Personal Data Protection Unit
101,Carvents House,Harrow HA1 1PD,UK.
8. In addition, with respect to data processed on the basis of consent, you have the right to withdraw this consent at any
time. You can withdraw your consent by sending a request to our e-mail address or postal address. The consequence
of withdrawing from consent will be the inability to process this data by us.
I have got acquainted with the information clause concerning personal data processing for study admission at the
Academy of Tourism and Hotel Management.
I give my consent to process my email address as regards admission to studies at the Academy of Tourism and Hotel
Management and further contact.
Date: ......................................... I confirm the correctness of the data in this application
with my personal signature
...................................................................
(candidate’s signature)
Recipient of the application form
......................................................................
(date, signature)