MEMBER’S PROFILE

Name _policher__________ralph
nicole________pahilangco______________________
{Last Name} {First Name} {Middle Name} PHOTO (2X2)

College _1st year_______ Degree Program & Major ___bsit_________

Civil Status __single_____ Gender __male____Religion
___roman__catholic________
Place of Birth _____cebu city_____________Date of Birth ____sept 21
2000______
Present address sambag 1 cebu
city____________________________________
Contact No. ____09514589780_________ Email
____gladex14@gmail.con_________________
Position: ____roam-p4________________________________

EDUCATIONAL BACKGROUND

Name of School Year Graduated

Elementary: _____cv diez elem school_____________________
______________
High School: ______st paul ubiversity surigao__________________
______________
College: _________uv__________________
______________

AWARD/S RECEIVED

______no_____________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
__

ORGANIZATION/S AFFLIATED
______no_____________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
__

Trainings Attended: [Use separate sheet if necessary.]

Title Date Venue

_____________________________________________________________
_____________________________________________________________

“An internationally recognized private non-sectarian university committed to academic

excellence, transformational, and innovative education.”
Corner D. Jakosalem, Colon St., Cebu City 6000• uv.edu.ph
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Are you a member of the other organizations in the university? [Use check
mark in the answer chosen]
No _______✓__ Yes__________
If yes, write the name of the Organization(s) you are affiliated with.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Are you affiliated to any Organization (s) outside the University?

No ____✓_____ Yes__________
If yes, write the Organization you are affiliated with.
_____________________________________________________________
_____________________________________________________________
__________________________________________________

FILLED UP:
________________________________
Signature over Printed Name / Date

“An internationally recognized private non-sectarian university committed to academic

excellence, transformational, and innovative education.”
Corner D. Jakosalem, Colon St., Cebu City 6000• uv.edu.ph
Privacy Notice
This privacy notice outlines the data collection, sharing, confidentiality, and data security, retention and disposal policies of the University of the
Visayas Inc. in compliance to Republic Act No. 10173 otherwise known as the Data Privacy Act of 2012 and the Implementing Rules and Regulations
of the National Privacy Commission.

Collection of Information
The University of the Visayas collects personal information that are necessary and compatible with the declared, specified, and legitimate purposes
using data processing forms, such as, but not limited to:
 Personal contact information (e.g., name, home address, city address, email address and mobile/phone number);
 Demographic information (e.g., race, date of birth, age, gender, citizenship, nationality, religion);
 Contact information of parent and/or legal guardians (name, address, mobile/phone number)

Purpose of Collection
The University of the Visayas collects and uses personal information only as necessary for the purposes which it was obtained. UV may use the
personal information you provided in this form for documentation purposes and for compliance with legal educational requirements.

Data/Information Sharing
The data collected by University of the Visayas are shared internally for Official Business Purposes only. UV shall not share your personal information
with any third party that intends to use your personal information for commercial purposes, unless you have freely given a specific and informed
consent. UV may share your personal information with third parties for other purposes limited to the following circumstances:
Parents and Legal Guardians. UV may disclose your personal information to your parents and legal guardians in the communication of
your academic progress and other such matters that they may inquire concerning you.
Researchers. UV may impart your personal information to researchers in the conduct of their study, and other persons with legitimate
interest for use in generating statistical inferences and profiling.
Grantors, Benefactors and Sponsors. UV may share your personal information to private entities and/or government organizations that
offer scholarship privileges. These parties most likely access and further process your personal information in the course of their scholarship
evaluation and documentation.
Insurance Providers, Contractors, and Other Service Providers. UV may employ service providers and contractors to provide services
on its behalf. These third parties may request, come to access or otherwise process your personal information in the course of providing
these services.
Industry Partners. UV may recommend you to industry partners offering employment opportunities and may be inclined to access and
process your personal information in the scope of their human resource evaluation.
Legal Requirements. UV may disclose your personal information if it is required to do so by law.

UV shall ensure that all employees and such third parties, who use data processing facilities or handle personal data, must sign a confidentiality or
non-disclosure agreement before the work starts or prior to being given access to personal data.

Data Security, Retention and Disposal

Personal data in the custody of the University may be in digital and/or electronic format and paper based. UV ensures that personal data under its
custody are protected against any accidental or unlawful destruction, alteration and disclosure as well as against any other unlawful processing.

In order to keep your personal information secure, UV has implemented a number of security measures which includes keeping data processing forms
in a secured cabinet strictly accessible only to authorized employees of the university.

Personal data under the custody of UV will be retained only for as long as it is necessary for the fulfilment of the purposes which the data was
collected, taking into account the need to answer queries and comply with legal requirements under applicable laws. This means that we retain your
personal information for a period of 5 years after your last interaction with us. When the personal information collected is no longer required, data
processing forms containing personal data are shredded or incinerated.

Your Rights
UV recognizes that every data subject is entitled to be informed of the processing of his or her personal information and be granted reasonable access
to such by the personal data controller or personal data processor. Other rights include:
 Right to dispute the inaccuracy or error in the personal data;
 Right to request the suspension, withdrawal, removal or destruction of personal data; and
 Right to complain and be indemnified for any damages sustained due to inaccurate, incomplete, false, unlawfully obtained or
unauthorized use of personal data.

Contact Us
Data subjects may inquire or request for information regarding any matter relating to the processing of their personal data under the custody of the
University of the Visayas, including the data privacy and security policies implemented to ensure the protection of their personal data, through the
University’s Data Protection Officer:
 Phone @ 253-4384 Local 124
 Email at dpo@uv.edu.ph
 Mail at Data Privacy Office, 2nd Floor Inday Pining Building, University of the Visayas, Colon Street, Cebu City
 Data Privacy Contact Form available in the University website (uv.edu.ph)

ACKNOWLEDGEMENT

By affixing my signature below, I hereby acknowledge that I have read and understood this Privacy Notice; and thus, consent to the collection,
processing, storage, sharing, use or disclosure by University of the Visayas Inc. of my Personal Information and/or Sensitive Personal Information, to
the extent that such collection, processing, storage, sharing, use or disclosure are required or necessary to enable University of the Visayas to comply
with their respective obligations under applicable laws, rules and regulations.

Furthermore, I explicitly assert that the person whose name is affixed below is my authorized representative, and therefore allowed to inquire and
request to collect on my behalf my personal data and educational records.
“An internationally recognized private non-sectarian university committed to academic
excellence, transformational,
Name of Authorized Person and innovative education.”
Relationship
1) ____________________________ ___________________________
C o r n2)e r ____________________________
D . J a k o s a l e m , C o l o n S t . , C___________________________
ebu City 6000• uv.edu.ph