Individual Rights Request Form

1. Details of the person who is the subject of the information (Data Subject)

Name:

First

Last

Address:

Phone:

Email:

Are you:

Member of StaffStudentOther

Further information for example your Staff/Student ID

2. If you are acting on behalf of the data subject, please fill your details here

Name:

First

Last

Address:

Phone:

Email:

Relationship with Data Subject:

You will need to supply evidence of the identity of the person making the request if different from the data subject by sending a copy of valid ID document to information.governance@canterbury.ac.uk The University considers valid ID Documents copy of driving licence, copy of passport, copy of birth certificate You should also send a copy of written authority from the data subject to information.governance@canterbury.ac.uk

I certify that the information I have given on this application form is true and accurate. I understand it is necessary for the University to receive copies of ID Documents to confirm My/Data Subject’s identity and copies of written authority from the data subject. I also understand that it may be necessary for the University to contact me using the email address provided on this form to obtain more detailed information.

Declaration

I declareI declare on behalf of Data Subject

Please let us know which rights you want to exercise:

Your Rights to Excercise

Right of accessRight to Data PortabilityRight to RectificationRight to Restriction of ProcessingRight to Erasure (right to be forgotten)Right to objectRight to freedom from automated decision makingOther

If 'Other' please give detials

Details of Information required

Student: If you are a student, we will normally automatically search the following sections for personal data: Planning and Academic Administration; Student Support, Health & Wellbeng; and the academic departments you have studied with as part of your programme of study.Employee: If you are an employee, the University will normally automatically search the following sections for personal data: Human Resources and the department(s) in which you work(ed)Visitor: If you are a visitor, Please tick below any departments you have been in contact with which you would like to be searched for relevant data. A search will not be made unless you tick the relevant box.

If you are a Visitor

LibraryHealth & SafetySports CentreChaplaincySecurityFinanceInsuranceCCTV

Part 2

Please provide us with any additional information which could be useful to locate your data:

Additional information regarding where we will need to search

Please include add any other departments you have been in contact with which you would like to be searched for relevant data.

Faculties/Schools:

Departments

Additional information regarding what we will need to search

You might not want all the personal data that the University holds about you. We may respond more quickly if you explain this and identify the specific data you want. Please use this space to provide as much detail as possible about the information you are requesting, for example by stating specific documents you require, individuals or class of individual to which you refer in terms of the emails and other communications, format (paper or electronic format such as application form, letter, email etc). Please, give us also a rough specification of the date range ie. when the data was created or processed

Additional Information:

Individual Rights Request Form

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