CONSENT FORM FOR PERSONAL AND ACADEMIC INFORMATION

In line with the Data Privacy Act of 2012, I am giving my full consent to the
University Student Council (USC) and the Central Student Council (CSC) of the
University of the East Manila and Caloocan Campuses, respectively, to collect my
personal and academic information to be used in the affidavit/sworn statement to be
filed before the Commission on Higher Education (CHED) with regard to the
scholarship fiasco within our University. I duly recognize that my personal and
academic information are both vital in the action to be performed by the councils. I
understand that I have the right to revoke the foregoing consent at any time by
notifying the USC/CSC.

AINA MARGAUXE G. JACINTO May 24, 2021

Signature over printed name Date signed