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ANNEX A

DATA PRIVACY CONSENT FORM

We at the Technology Application and


Promotion Institute are committed to to the NPC Circular 16-03 or Personal
provide you with the services involving Data Breach Management.
application and promotion of science
and technology pursuant to Executive Personal information collected are
Order No. 128 and RA 7459 while stored and later on disposed of via
implementing safeguards to protect your shredding and permanently deleted in
privacy and keep your personal data our electronic files in accordance to R.A.
safe and secure. No. 9470 otherwise known as National
Archives of the Philippines Act of 2007.
Processing of Personal Data
Rights of the Data Subject
The personal information being collected
which may include your name, contact As the Data Subject, you have the right
numbers, email address, home and to be informed of the personal
office address, photos, and the like, may information being collected, processed,
be used for (1) evaluation of the and stored by TAPI as well as to access,
request/proposal; (2) monitoring of the object, rectify, and block the same. For
approved project; (3) sending questions or concerns, you may contact
notifications/updates; and (4) other our Data Protection Officer through the
similar activities, in connection to the following details:
Data Subject’s present proposal or
request for assistance and the (02) 837 2071 local 2162
succeeding projects/requests that the info@tapi.dost.gov.ph
Data Subject may have with TAPI. Said
information will also be shared within I have read this form, understood its
DOST System for the purpose of contents, and consent to the processing
informing and/or inviting the data subject of my personal data. I understand that
to any other events, promotions, my consent does not preclude the
proposals, and other activities of DOST existence of other criteria for lawful
System. Further, said information will be processing of personal data, and does
shared within and used by the DOST not waive any of my rights under the
System for statistics purposes. Data Privacy Act of 2012 and other
applicable laws.
Data Protection

We shall implement reasonable and ________________________________


appropriate organizational, physical, and (Signature over Printed Name)
technical security measures for the ________________
protection of personal information which (Date)
we collected.

Only authorized personnel are permitted


and have access to the collected
information who will treat any
confidential information under strict
confidentiality. In case of breach, TAPI
shall notify you and inform the National
Privacy Commission (NPC) in
accordance

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