Form for families that want to host

Dear Sir/Miss, we would like to inform you that Regulation 679/2016/EU provides for the protection of individuals and other subjects with respect to the processing of personal data. According to the legislation indicated, this processing will be based on the principles of correctness, lawfulness and transparency and protection of your privacy and your rights. Pursuant to article 13 of Regulation 679/2016/EU, therefore, we provide you with the following information: 1. The data you provide will be processed for the management of activities as a User of the services of Victoria Languages and Cultures Srl, Data Controller, for example, to pursue activities of: – Host Families 2. The processing will be carried out manually, computerized also using CRM software, telematics and, possibly, instrumental for images and videos, the latter for organizational and administrative purposes only for registration and management of the case. Only the contact details can also be used to keep you updated on the initiatives and programs organized by the Data Controller. The processing will be carried out by those in charge of the Data Controller. 3. The provision of data is mandatory for the management of activities as a User of the services of Victoria Languages and Cultures Srl, Data Controller, and any refusal to provide such data will result in failure to perform the services. 4. Personal data may be communicated to external structures, for example to students, host families, State Bodies, Bodies responsible for legal controls, schools, universities, Public or Private Bodies limited to the purposes of the Project and/or cultural exchange for the correct execution of the service and for legal obligations. The processing will also concern personal data falling within the category of particular data, as indicated in Article 9 of Regulation 679/2016/EU, i.e. data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, as well as genetic, biometric data intended to uniquely identify a natural person, data relating to the person's health or sexual life or sexual orientation. The processing that will be carried out on such particular data, within the limits indicated by the relevant Authorizations granted by the Guarantor Authority and concerning the state of health and sexual life and associative bodies and foundations, subject to your consent, as suitable for revealing: • the state of health; • religious, philosophical or other beliefs; • political opinions, membership of trade unions, parties, associations of a political or trade union nature; • social and political problems: poverty, poverty, socio–family problems, political refugee status and prison detention, has, as its purpose, the management of activities as a User of the services of Victoria Languages and Cultures Srl, Data Controller. The processing will be carried out in manual, computerized, telematic and, possibly, instrumental methods for images and videos for organizational and administrative purposes only for registration and management of the case. The processing will be carried out by the data controller's representatives. The particular data described above will not be disclosed pursuant to Regulation 679/2016/EU but may, if necessary, be communicated to external structures, for example to students, host families, State Bodies, Bodies responsible for monitoring the law, schools, universities, Public or Private Bodies limited to the purposes of the Project and/or cultural exchange for the correct execution of the service and for legal obligations.We inform you that the provision of these particular data is optional for the management of the service by the data controller but any refusal to provide such data will result in the non-execution of the service or failure to pursue the activities referred to in point (1). 5. As part of its activities, Victoria Languages and Cultures Srl has decided to carry out specific photographs and audio/video recordings to illustrate and make known, enhancing them, its activities with the sole purpose of illustrating the activities and the environment in which they take place. We therefore ask you to carefully read the following and express your will and consent: based on the Reg. 679/2016/EU the processing will be based on the principles of correctness, lawfulness and transparency and protection of your privacy and your rights. Any relationships with the press, with television broadcasters or film producers, with graphic technicians are always evaluated by the people involved in moments of collective discussion and in-depth analysis by the Data Controller. The provision of this personal data is optional for the management of the aforementioned activities and any refusal to provide such data does not entail any consequences, except the impossibility of participating in the filming and photographs. Such personal data may be communicated to external structures, for example printing companies, for the correct execution of the activity and disseminated for the purposes inherent to the collection. 6. The data will be processed and stored for the entire duration of the relationships established between you and our Company, and, subsequently, for the duration necessary to fulfill our relevant legal obligations and to keep it updated on the initiatives and programs organized by the Data Controller.. 7. In relation to the data subject to the processing referred to in this information, the interested party is granted the right at any time to: • Access (art. 15 EU Regulation No 2016/679); • Corrigendum (art. 16 EU Regulation No 2016/679); • Cancellation (art. 17 EU Regulation No 2016/679); • Limitation (art. 18 EU Regulation no. 2016/679); • Portability, understood as the right to obtain data from the data controller in a structured format commonly used and readable by an automatic device to transmit them to another data controller without impediments (art. 20 EU Regulation No 2016/679); • Opposition to processing (art. 21 EU Regulation no. 2016/679); • Revocation of consent to processing, without prejudice to the lawfulness of the processing based on the consent acquired before the revocation (art. 7, par. 3 EU Regulation n.2016/679); • Propose a complaint to the Guarantor Authority for the Protection of Personal Data (art. 51 EU Regulation No 2016/679). The exercise of the aforementioned rights can be exercised by written communication to be sent by e-mail to the address info@victoriateam.it or registered letter with return receipt to the address Victoria Languages and Cultures Srl, Strada Cognento, 92 – 41126 Modena 8. The data controller of personal data is Victoria Languages and Cultures Srl, Strada Cognento, 92 – 41126 Modena

*I hereby declare that I have received the information on the rights connected to the processing of my/our personal data from Victoria Languages and Cultures Srl, processing aimed at fulfilling all legal obligations. I therefore give my/our consent to the processing of my/our data for the purposes described above pursuant to the privacy law.

I declare that I have read the
GENERIC INFORMATION

I the undesigned DECLARES that nothing prevents me from issuing the following authorization, assuming all responsibility for the lack of truthfulness of what has been declared also in the name and on behalf of the other parent, or of the person holding parental responsibility for the minor (in the case of a minor); I also declare that I assume the responsibility of authorizing the relevant photographic, video, telematic, interview and related broadcasts via TV, press, etc.

*I hereby also express my/our consent by authorizing Victoria Languages and Cultures by both parents

PROGRAM NAME

Program Name*
—UGAAUCSCOST AND EMILIA SCHOOLSACADEMIC YEAR/QUARTER/TRIMESTER IN ITALYIMVECLASS EXCHANGES – ATHENS ACADEMYCLASS EXCHANGES – WA PERTH HIGH SCHOOLSLICEO FANTI & PERTH HIGH SCHOOLSPERTH HIGH SCHOOLS

HOST FAMILY INFORMATION

Family Surname*

Area Code*

City*

Country*

PARENT 1 INFORMATION

Parent 1 Name*

Parent 1 Surname*

Parent 1 Date of Birth*

Parent 1 Job*

Parent 1 E-mail*

Parent 1 Phone*

Parent 1 Home Address (Street name and number)*

Parent 1 Area Code*

Parent 1 City of Residence*

Parent 1 Country of Residence*

PARENT 2 INFORMATION

Is Parent 2 present?*
—PresentAbsent

OTHER USEFUL INFORMATION FOR THE PROGRAM

Other Family Members (Name and Date of Birth)*

School Attended by the Children*

Hobbies and Interests*

Why Do You Want to Host a Foreign Student?*

Boy/Girl Preference?*
—BoyGirlIndifferent

Have you already hosted foreign students? If YES, tell us more*

Pets in the Family? If YES, tell us more*

Other Languages Spoken in the Family? If YES, tell us more*

Membership in Clubs, Religious Communities? If YES, tell us more*

If there are smokers at home, can you confirm that they will smoke outside during the program (Balcony/Garden)?*
YESNO

Do you confirm that the Student will have a Single Room?*
YESNO

Describe Your Daily Routine*

What are the Rules of Your Family?*

How do you plan to get the student to participate in family life?*

We ask you to express a rating from 1 to 6, where 1 indicates TOTALLY DISAGREE and 6 TOTALLY AGREE, with respect to the following points:

We host a Foreign Student Because it is an Opportunity to Learn a Foreign Language*
123456

It is difficult to live with people who have cultural values and daily habits different from ours*
123456

This Type of Experience – Intercultural Exchanges – Contribute to Raising People in the Sign of Tolerance and Respect for Different Cultures*
123456

Curious to Know the Student’s Culture*
123456

How Disoriented the Student will Feel*
123456

*Data Processing: I hereby declare that I have received the information on the rights connected to the processing of my/our personal data by the organization, processing aimed at data collection and the fulfillment of all legal obligations. I therefore give my/our consent to the processing of my/our data for the purposes described above pursuant to the privacy law.

*Permission to Provide Relief: I hereby further express my/our consent for Victoria Languages and Cultures to provide relief to our child in case of need.

AUTHORIZES your own (and/or that of the minor) photographic, video, telematic, interviews and related broadcasts via TV, press, etc.; I also authorize the publication of photos/videos that portray you, on our website, on paper and digital information materials and on our social channels for marketing purposes, to accompany the said photographic, video, telematic and interview shots, of the statements released by myself and/or by the minor himself, in the case of a minor, as well as my/her name, surname, type of school, age and city and which may be republished in similar services or in contexts that do not damage my dignity and that of the minor. DECLARES furthermore, also in the name and on behalf of the other parent, in the case of a minor, to waive any consideration that may arise from the publication of said images, statements and my personal data and that of the minor. I also declare, also in the name and on behalf of the other parent, in the case of a minor, that I have nothing to claim from the undersigned Company for any present and future reason for the above publications. I declare that, in light of the provisions of the civil code regarding parental responsibility (art. 316, 337 ter, 337 quater), the choice made was shared by the parents.

I authorize the above*
—YESNO

“YOUR ROLE AS A HOST FAMILY” *
I declare that I have carefully read the information*
YES

Date of Issue*