Apart and Together!

The 18th Girl Scout International e-Camp, Korea 2021

August 1 - 20, 2021

Application Form
Name of National
Organization Bangladesh Girl Guide Association
Name Given
name Moontaha Binte
Surnam
e Kibria
Date of Birth
29/11/2003
Age
17
Gender
Female
E-mail
moontahakibria29@gmail.com
Tel
008801798660560
Position in Girl
Scouting
*Position in Girl Scouting: e.g., Brownie/ Girl Scout/
Ranger/ Adult Leader

Consent to Processing of Personal Information (for

International Participant)

❖Consent to collect, use and disclose personal

information
Person above has verified below contents and
consents for Girl Scouts of Korea (GSK) to collect, use
and disclose personal information.
Categories of Name / Nationality / Date of Birth
Personal /
Information Age / Gender / Interest/
collected Photographs and Video
recordings/ Group & Position in
Group / E-mail address / Phone &
Fax number /
Information of Registered

Organization (Group) &

Responsible Contact Person &
Contingent Leader (Name, Phone
&
Fax number, E-mail address)
Purpose to Participation in “The 18th Girl Scout
collect and use International e-Camp, 2021”
Personal
Information
Usage and ◐ Written Content: Until changing
Reservation to database or late-February of
Period 2024
◐ DB: Semi-permanent usage and
reservation

Right to
Withdrawal of You have right to withdraw
Consent consent. However, it is
impossible for you to
participate in the e-camp in
that case.

❖Consent to pr ovide personal information to the

third party
Person above h as verified below contents and

consents for Girl Scouts of Korea (GSK) to provide

personal information to the third party.

Personal The website development
Information company 'Sky of red'
Receiver
Purpose to To sign up for membership in
collect and use website
Personal
Information
Categories of Name / Nationality / Date of Birth
Personal / Gender / E-mail
Information
provided
Usage and 3 years
Reservation
Period
Right to
Withdrawal of
Consent You have right to withdraw
consent. However, it is
impossible for you to
participate in the e-camp in
that case.

❖Parental Consent (If you are under the age of 14)

We are committed to safeguarding the welfare of all
children and young people involved in our
organization. If you are under 14, please ask a
parent/guardian to sign the following.
Parent/guardian is consent to their child taking part in
the e-camp as a guardian.
Right to
Withdrawal of You have right to withdraw
Consent consent. However, it is
impossible for you to
participate in the e-camp in
that case.
Signature of
parent/guardian

I confirm the correctness of all data with my signature.

Signature of applicant Moontaha