Philippine College of Criminology

641 Sales St. Sta. Cruz Manila

GENERAL EDUCATION DIVISION

LANGUAGE DEPARTMENT

Data Request Application

Name :
Address :
Date of Birth :
Age :
Gender :
Phone/ Cell no. :
Email Add. :

Details of Data Request (Station details, period, Event details etc)

Requesting for a 25 different Police Report as final requirement of the course.
Police Report requested should never be a sensitive/high profile case.

Title of Research Project/ Purpose of the data request

Will be documented as a future reference of the students in their Technical Writing Course.

I agree the terms and conditions for the data usage.

__________________________________
Signature over Printed Name

Noted by: Approved by:

_____________________________ _______________________________
Prof. Ferdinand D. Piñon Prof. Recuerdo G. Lacsamana
Technical Writing Professor Director, General Education
This College This College

Philippine College of Criminology, 650 Sales St., Sta. Cruz, Manila, MM, Philippines 1003 • (632) 733-1607 • www.pccr.edu.ph 1 of 2
 Philippine College of Criminology
641 Sales St. Sta. Cruz Manila
GENERAL EDUCATION DIVISION

Terms and conditions

 Once the requirements are met, entities seeking access to data are required to submit their request on
organization/personal letterhead.
 All the data request must be accompanied by brief statement of purpose and signature of
authorization from the professor concern.
 The data received must use only for the intended purpose.
 Data obtained under such a request may not be sold or rented.
 Commercial use of data obtained under such a request is prohibited.
 Recipients do not attain ownership of the data and credits should be given to the data providing
organization.
 Such data may not be shared or distributed, and all copies must be destroyed when the researcher
completes the analysis or report.
 Data, copies of data, and all reports must be maintained in a secure environment to prevent
unauthorized access.
 In the event a request is rejected, specific reasons shall be given and if appropriate, may include
information concerning possible remediation.
 This authorization letter is valid only for a period of 3 months from the date of approval and should be
renewed for further data request.

I agree the terms and conditions for the data usage.

__________________________________
Signature over Printed Name

Philippine College of Criminology, 650 Sales St., Sta. Cruz, Manila, MM, Philippines 1003 • (632) 733-1607 • www.pccr.edu.ph 2 of 2