limitation) collection, recording, systematization, accumul ation, storage, clarification (updating,

cbanging), extraction, use, transfer (including trans fer to third parties - institutions and
organizations that, in accordance with the Fedcral Law "On Persona! Data" , Kuban Statc
University may cntmst the proccssing of perso na! data, or is obliged to prov idc persona! data in
accordance with th e current legislation of th e Russian Federation) , <lepersonalization, blocking,
<lcletion, destruction, cross-border lrans fer of' persona! data (in the case or my scn<ling abroad) to
a foreign part11er university (an organization that has a contraetual or partnership relationship
with Kuban State University) in order to receive an invitation and further apply for a visa, as
well as realizing exclusion of any other actions with my personal data provided for by the current
1egislation of the Russian Federation.
3. J have the rigbt to free access to my personal data processed by the Kuban State University,
their withdrawal (in whole or in pait) or blocking (on a persona! rcqucst) .
4. Consent may be withdrawn by a written notification of the Kuban State Un iversity at the legal
address.
5. Upon enrolling in additional educational programs at the Kuban State University, J am
familiar with the "Regulations on the procedure for organizing and carrying out work on the
processing and protection of personal data processed in personal data information systems",
"Personal data processing policy of the Federal State Budgetary Educational Institution of
Higher Education "KubSU", rights; mclobligations in the field of persona! data protection.
I authorize the processing of my personal data in an automated and non-automated way from the
moment of signing the consent during the entire period of my studies at the Kuban State University,
and after its completion - to store in an archive, the storage periods of which are established by the
cun-ent legislation of the Russian Federation.
I confmn that all of my personal data listed in the Consent was received by Kuban State University
personally from me and is reliable. I unde1take to promptly notify the Kuban State University of each
change in my personal data. I do not abject to my persona! data being available to employees of the
structural units of the Kuban State University implementing additional educational programs.
This Consent is valid from the moment of its signing during the entire period of my studies at the
Kuban State University and the terms established by the cunent legislation. I confom that by giving
such Consent, I am acting of my own will and in my own interests.

"~~~ 2022
Il

(i ate , 'i!Jt name)

 To the Rector of Ku ban State University
(350040, Krasnodar, 149 Stavropolskaya Str.)
Mikh ail B. Astapov

l'rum J~
:'_ _'J __.
..________
fi,// name )
__ ] ~_
(ci1i: e11sl,ip)
APPLICAllON

r would likc to be admittcd as a studcnt of the Preparatory Depat1ment for Foreign Nationals and
Stateless Persans for n·aining on full-rime Pre-university course program. The program implies e-
learning technologies. The program Joad is 2380 academic hours. The period of study from
"_ '' O~U; 202'k to " _ " ~ 202.a_;
1
1. provide information about myself: . ... -~ · , ,

1. Sumame, name, patronymic:_ ....,

~~ 1~
.......~,...2....- .....~- ~_,._,_,="--'-.,_,_ _ __ __ _ _ _ _ __

2. Date ofbi11h (dd.mm.yyyy): Q~ ,. û

3. Pass ort name date of issue issued b :
,o 2 ~
·p6 • Ü} 0 ~ l) ~ ::).
, Q1
4. ~orne addt s (zip code,,Rlace ofregistration / 1 sidence):
\ffl\1-'l¼ .,~~ -YD~ . )! nw.G~
t509) 'b11~ ~q 91
tel. mobile: (
e-mail ~~ 1.i:ib! o.rmW. .Lo rlill\
5. EdJ:.:.iaocurn~ ~educational document and qualifications:

(cettificate/diphmla: bachelor i specialist / master)

Full name of the educational organization in wbich the main educational pro gram is mastered /

mastered l{;Jl,a.ro 4ilg,l\l Jfü...~~

Series, number of tbe document on education / document on education and qualifications, date
of issue:
-------------------------------
Field of study: 0 Humanities □ Economies D Medicine/Biology
.J Engineering 0 Natural sciences

2022 ro.n

r also confüm with my persona! signature the consent to the processing of persona! data -

Appendix No. l to this application. ~ µ)6. (signature)

 CONSENT
to the processing of persona ! data of an indi viduul for lhe purpose of studyin
g al Pre-uni versity
course program

r, At(\h\On.,j~ ~ , ÇlL\!M'J··H~ ~ ~llih.

(las/ / ~ /(11111' , fllllf'IJ/1_\ 'lllil' (in ,,,,, /l '(',\'('/I (~~~ ,\n of the s uly el'I of / H! .- . . ,
rS0/1(1/ da a) rcc;1d1ng al:
passporl~en ~~i '/o.\\_\1~.00~ ~5 _ , issued by (by) :~ ~ ~\~il.t J$hcn
1 hcrcby givc 111 y~ t to lhc Fcdcral Statc Budgetary Educalional l~~(lti
: ~ '}()l}..
on o fig r Educati on
"Kuban St ale University" (hereina fler referred lo as Kuban State Uni versity)
(350040, Krasnodar,
Stavro pülskaya St., 149) for process ing both usi ng au tomation too ls and wilhoul
using such toul s ,
including the collection, recor<ling, systemati zation, accumu lation, storage ,
clarification (updating
changin g), extrnclion, use, transfer (distribution, provision, access) , deperso
nalization, blocking,
ddction, destruction) of my pcrsonal data, which includc: 1. Data of th e main
identity document
lpassport data): last namc, first namc, patronymic; Date and place of birth
; citizcns hip (rcgi on of
rcsidcncc) ; scrics and numbcr of the passport; by whom and when issucd; floor;
addrcss of the pla<.:c
of rcsidcncc (rcgistration), including a photocopy of this document (main page
and registration page);
2. Biomctric data (photo to ensure personal identification, registration of the
studcnt's persona !
file):
3. Contact details: tclcphone (mobile, home, work), e-mail addrcss;
4. Information about cducation: data of the educational document / educational
document and
qualifications, acadcmic degree, ac_~demic title, including photocopies of thcse
docum ents, data
on the specialty, information on forcign language proficiency;
5. Place of work, position;
6. Data of other documents, which, ta.king into account the specifics of
trammg and in
accordance with the legislation of the Russian Federation, must be prcscnt
ed by me upon
admission tu training or in the process of trainù1g ;
7. Othcr information indicated by me in the application for enrolling me
in the nurnbc r of
studcnts in the study group for training in an additional cducational program
, information
received as a rcsult of my submission of documents upon admission to study
and (or) in the
proccss of studying at the Kuban Statc University, othcr info1mation about me
necessary for the
Kuban State University to conect ly document the legal relationship bctwccn
me and th e Kuban
Statc University.
J agree tbat my persona] data - last name, first name, patronymic, field of study,
additional
educationaJ program, group may be included in public somccs of persona! data
of the Kuban Statc
University.
J am aware that:
1. Kuban State University processes my personal data in order to: ensure
compliance with the
Ferlerai Law "On Persona! Data", the current legislation of the Russian Federat
ion in the field of
persona! data protection and other regulatory legal acts; correct documentation
of legal relations
between me and Kuban State University, fulfillment of contractual obligations;
correct execution
of ail technological processes for working witb mate1ial media (inclucüng doctlme
nts) containing
personal data obtained upon admission to training, in the process of training,
after comple tion of
training (in cases provided for by the cun-ent legislation of the Russian Federat
ion); providing
my education; quality control of my training; assistance in providing employ
ment and training:
providing information to state bodies and institutions of the Russian Fe<lera
tion in Lhe rnanncr
prescribed by the cmTent legislation of the R.ussian Federation; ensuring the
provision of social
guarantees to me, provided for by the current legislation of the Russian Federa
tlon; cnsuring
guarantees and security in accordance with the requiremeuts of the law; ensurin
g the safely of
the property of the Kuban State University; use in manage rial, administ.rative
and other activittes
of the Kuban State University not prohibi ted by law.

2. The process i ng of peniona l data include s the implem en lntion or

any actions (opernt ions) in
relation to my persona! data that are neccssa ry to achieve the abovc goals,
including (without