CONSENT TO PERSONAL DATA PROCESSING

«____» of ____________, 20__

I, _______________________________________________________________
(please, indicate your name, passport number, date and place of issue, home address)
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
according to the Federal Act 27.07.2006 № 152-ФЗ «About personal data»
express my full consent to the processing of my personal data by the Federal State-
Funded Educational Institution of Higher Education the Russian Presidential Academy of
National Economy and Public Administration (RANEPA), location: Russia, 119571,
Moscow, Vernadskogo Prospect, 82.

Personal data include:

-first name, second name, patronymic (father’s) name, other names according to
the passport, former names and date, place and the reason of their change
-citizenship
-date and place of birth, passport information
-address of residence, E-mail, phone number
-information about educational level
-health information, including information about disability
-personal photos
-information needed for enrollment.

The processing of the personal data means that the data will be collected, recorded,
accumulated, organized, stored, itemized (renewed), used, transferred, depersonalized,
blocked and terminated.

RANEPA is not eligible to transfer personal health information.

I am informed, that I am eligible to withdraw the consent (please indicate the

reasons). In this case the information that has been already included in the documents within
the period of its validity may be transferred to a third party.

Date Signature