6/8/2022

RUKHSHONA ALIEVA
(name and surname)
7/11/2002, Dushanbe
(date and place of birth)
A.Navoi street21/7, apartment 22 , 734000 Dushanbe
(home address)
A.Navoi street21/7, apartment 22 , 734000 Dushanbe
(correspondence address)
403512003
(passport number)
To:
His Excellency
President of the Polish-Japanese
Academy of Information Technology
in Warsaw

Application for Admission

I wish to be admitted for the Engineer programme at the Polish-Japanese Academy of Information Technology, at
the Faculty of Information Management, Field of Information Management, type of study: full-time, language of
instruction: English.
In witness of the data contained in this above application.

Date and signature of the candidate

I agree to the processing of my personal data for the purposes of enrolment for studies, documentation of the progress of my
studies and performance of other tasks and rights set forth in the applicable law, including the use of the above mentioned
data statutory, statistical and archival purposes.
I declare that the provision of data is voluntary, but necessary to achieve the purposes for which it is collected.

INFORMATION CLAUSE ON THE PRINCIPLES OF PERSONAL DATA PROCESSING

Pursuant to Regulation of the European Parliament and of the Council (EU)2016/679 of 27 April 2016 on the protection of
individuals with regard to the processing of personal data and on the free movement of such data and repealing Directive
95/46/EC (General Data Protection Regulation) (hereinafter referred to a s "GDPR"), we inform you about the rules of
processing your personal data by the Polish-Japanese Academy of Information Technology (hereinafter referred to a s
"PJAIT") , Koszykowa Street 86 (02-008) Warsaw, phone: (22) +48 22 58 44 500. PJAIT,as the Data Controller, protects your
personal data, fulfilling the requirements of GDPR. The Controller guarantees that your personal data will be processed only
for specific, explicit and legally justified purposes.
1. Data Controller (Administrator)
Polish-Japanese Academy of Information Technology, Koszykowa Street 86, 02-008 Warsaw, phone: +48 22 58 44 500,
(hereinafter referred to as PJAIT or the Administrator), acts as the Data Controller.
2. Data Protection Officer
The Administrator appointed Data Protection Officer –e-mail: iod.pja.edu.pl
3. The purpose and the legal basis for processing personal data
Your personal data will be stored for the duration of your studies and until we (or another processor) possess one of the legal
bases in accordance with the GDPR (RODO). When a candidate is enrolled, his or her personal data will be processed in
order to provide educational service, including documenting the progress of study and performing other necessary tasks,
according to Article 6(1)(b) and (c) of GDPR, e.g. for statistical, statutory and archiving purposes.
4. Period of storing of personal data
Personal data of study candidates will be stored for 6 months from closing of recruitment. If a candidate is successfully
enrolled the data will be processed in order to provide proper educational service from the date of enrolment for the period the
provision of service is continued. For data in the student file (teczka studenta) the storage is envisaged as 50 years since the
last year of service provision In case of data provided by individuals who consented for it to be used for marketing and
advertising purposes (point 9 of this clause) – consent may be withdrawn at any time.
5. Categories of personal data users
Data will be processed by PJAIT employees or persons who has signed a service (civil-legal) contracts with PJAIT –
according to the relevant rights granted by the Administrator.Data may be transferred to recipients or other legal entities
involved in providing educational services of PJAIT, data processing services or legal rights to request data
6. Rights of the candidate
You have the right to:
 - access the contents of your personal data, including obtaining a copy of the data,
- request that personal data be corrected or supplemented,
- request the deletion of personal data,
- demand a restriction on the processing of personal data.
You have the right, at any time, to withdraw your consent. Withdrawal of consent does not affect the lawfulness of the
processing carried out on the basis of the consent before its withdrawal. If you consider that processing of your personal data
by PJAIT violates the provisions of GDPR you have the right to lodge a complaint with the supervisory body dealing with
personal data protection, e.g. the President of the Office for Personal Data Protection.
7. Transferring data to third countries
PJAIT has no intention of transferring personal data to a country outside of European Economic Area.
8. Processing by automated means
Your personal data will not be subject to automated decision making, including decisions based on profiling (Article 22 of
GDPR/RODO).
9. Processing of data for marketing and advertising purposes
A candidate may grant the right to the Administrator to process personal data for marketing and advertising purposes,
especially to inform about educational offer and temporary activities of PJAIT. The consent is voluntary and not necessary for
recruitment. Lack of consent will not influence recruitment decisions. If consent is given, data will be processed for marketing
and advertising purposes basing on the consent.
I declare that the data provided by me are accurate and true.

date and signature

DECLARATIONS OF CONSENT
I agree to the processing of my personal data for the purpose of recruitment for studies a t PJAIT,in accordance with the
Regulation of European Parliament and Council (2016/679) of 27.04.2016 regarding the protection of natural persons related to
the processing of personal data, the transfer of personal data and lifting of the directive 95/46/W E (general regulation of data
protection).

date and signature

I agree to receiving materials necessary for the provision of educational services (the contract) by traditional mail or electronic
media, as regulated by the act of provision of services using electronic media.

date and signature

I agree to the processing by PJAITof my e-mail address for the purposes of marketing and advertising of PJAIT products and
receiving from PJAIT promotional information via electronic media.

date and signature