Scheda di Partecipazione ai Programmi Ospitalità in Italia

Partecipant's Information

Name*

Surname*

Program's name*
---UGAAUCSCOSTACADEMIC YEAR/QUARTER/TRIMESTER IN ITALYIMVECLASS EXCHANGES - ATHENS ACADEMYCLASS EXCHANGES - WA PERTH HIGH SCHOOLS

E-mail*

Cell Phone Number* (with country code)

Date of Birth* dd/mm/yyyy

Nationality*
ItaliaAfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntartideAntigua e BarbudaArabia SauditaArgentinaArmeniaArubaAustraliaAustriaAzerbaigianBahamasBahreinBangladeshBarbadosBelgioBelizeBeninBermudaBhutanBielorussiaBirmaniaBoliviaBosnia ed ErzegovinaBotswanaBrasileBruneiBulgariaBurkina FasoBurundiCambogiaCamerunCanadaCapo VerdeCiadCileCinaCiproCittà del VaticanoColombiaComoreCorea del NordCorea del SudCosta d'AvorioCosta RicaCroaziaCubaCuraDanimarcaDominicaEcuadorEgittoEl SalvadorEmirati Arabi UnitiEritreaEstoniaEtiopiaFigiFilippineFinlandiaFranciaGabonGambiaGeorgiaGeorgia del Sud e isole Sandwich meridionaliGermaniaGhanaGiamaicaGiapponeGibilterraGibutiGiordaniaGreciaGrenadaGroenlandiaGuadalupaGuamGuatemalaGuernseyGuineaGuinea EquatorialeGuinea-BissauGuyanaGuyana franceseHaitiHondurasHong KongIndiaIndonesiaIranIraqIrlandaIslandaIsola BouvetIsola di ManIsola di NataleIsola NorfolkIsole BESIsole CaymanIsole Cocos (Keeling)Isole CookIsole FalklandIsole Heard e McDonaldIsole Marianne SettentrionaliIsole MarshallIsole minori esterne degli Stati UnitiIsole PitcairnIsole SalomoneIsole Vergini americaneIsole Vergini britannicheIsraeleJerseyKazakistanKenyaKirghizistanKiribatiKuwaitLaosLesothoLettoniaLibanoLiberiaLibiaLiechtensteinLituaniaLussemburgoMacaoMacedoniaMadagascarMalawiMaldiveMalesiaMaliMaltaMaroccoMartinicaMauritaniaMauritiusMayotteMessicoMicronesiaMoldaviaMonacoMongoliaMontenegroMontserratMozambicoNamibiaNauruNepalNicaraguaNigerNigeriaNiueNorvegiaNuova CaledoniaNuova ZelandaOmanPaesi BassiPakistanPalauPalestinaPanamaPapua Nuova GuineaParaguayPerPolinesia FrancesePoloniaPorto RicoPortogalloQatarRD del CongoRegno UnitoRep. CecaRep. CentrafricanaRep. del CongoRep. DominicanaRiunioneRomaniaRuandaRussiaSahara OccidentaleSaint Kitts e NevisSaint Vincent e GrenadineSaint-BarthSaint-MartinSaint-Pierre e MiquelonSamoaSamoa AmericaneSan MarinoSant Elena, Ascensione e Tristan da CunhaSanta LuciaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSiriaSlovacchiaSloveniaSomaliaSpagnaSri LankaStati UnitiSudafricaSudanSudan del SudSurinameSvalbard e Jan MayenSveziaSvizzeraSwazilandTagikistanTaiwanTanzaniaTerre australi e antartiche francesiTerritorio britannico dell'oceano IndianoThailandiaTimor EstTogoTokelauTongaTrinidad e TobagoTunisiaTurchiaTurkmenistanTurks e CaicosTuvaluUcrainaUgandaUngheriaUruguayUzbekistanVanuatuVenezuelaVietnamWallis e FutunaYemenZambiaZimbabwe

Place of Residence*

Dear Sir/Madam, We would like to inform you that Regulation 679/2016/EU provides for the protection of individuals and other subjects regarding the processing of personal data. According to the aforementioned legislation, this processing of personal data 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., the Data Controller, for example, to pursue activities of: - Summer English Programs - Academic year/term/trimester abroad and in Italy - Au pairs - Exchange Programs in Italy - Class Exchanges - Individual Programs Abroad 2. The processing will be carried out manually, computerized, telematic and, possibly, instrumental by images and videos, the latter for the sole organizational and administrative purposes for the registration and management of the file. The processing will be carried out by the people in charge of the Data Controller. 3. The provision of data is mandatory for the management of the activities as a User of the services of Victoria Languages and Cultures srl., the Data Controller, and any refusal to provide such data will result in the non- performance of the services. 4. Personal data may be communicated to external structures, for example to students, host families, State Bodies, Bodies responsible for controlling 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 compliance. The processing will also concern personal data falling within the category of special data, as indicated by art. 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 data, biometric data for the purpose of uniquely identifying a natural person, data relating to health or to the sex life or sexual orientation of the person. The processing that will be carried out on such data, within the limits indicated by the relevant Authorizations granted by the Data Protection Authority and concerning the state of health and sex life and associative bodies and foundations, subject to your consent, as suitable for disclosure:  the state of health;  religious, philosophical, or other beliefs;  political opinions, membership of trade unions, parties, political or trade union associations;  social and political problems: poverty, destitution, socio-family problems, political refugee status and prison detention, its purpose is to manage the activities as a User of the services of Victoria Languages and Cultures srl., the Data Controller. The processing will be carried out manually, or in a computerized, telematic and, possibly, instrumental way including images and videos for the sole organizational and administrative purposes for the registration and management of the file. The processing will be carried out by persons assigned to the task by the data controller. The particular data described above will not be shared, in accordance 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 controlling 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 providing these data is optional for the management of the service by the data controller, but any refusal to provide such data will result in the failure to perform the service or the failure to pursue the activities referred to in point 1). 5. As part of its activities, Victoria Languages and Cultures srl. has decided to take 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 read the following carefully and express your will and your consent. According to 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. Providing these personal data is optional for the management of the aforementioned activities and any refusal to provide such data does not entail any consequences, except for the impossibility of participating in the filming and photographs. Such personal data may be communicated to external structures, such as printing companies, for the correct execution of the activity and disseminated for the purposes related to the collection. 6. The data will be processed and stored for the entire duration of the relationship established between you and our Company, and, subsequently, for the duration necessary to comply with our legal obligations. 7. In relation to the data subject to the processing referred to in this policy, the data subject is entitled at any time to:  Access (art. 15 EU Regulation no. 2016/679);  Correction (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 of common use and readable by an automatic device in order to transmit them to another data controller without hindrance (art. 20 EU Regulation no. 2016/679);  Objection to processing (art. 21 EU Regulation no. 2016/679);  Withdrawal of consent to processing, without prejudice to the lawfulness of the processing based on the consent acquired before the withdrawal (art. 7, par. 3 EU Regulation no. 2016/679);  Lodge a complaint with the Data Protection Authority (Article 51 of EU Regulation no. 2016/679). The exercise of the above 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 is Victoria Languages and Cultures srl., Strada Cognento, 92 - 41126 Modena After reading and acknowledging the privacy policy above, I authorize the processing of mine and my child’s personal data as per current Italian directives (Law no. 679/16) User Information. I declare that, in light of the regulations of the Civil Code on parental responsibility (Articles 316, 337 ter, 337 quarter), the choice made was shared by both parents.

*I hereby declare that I have received the information on the rights related to the processing of my/our personal data by Victoria Languages and Cultures Srl, processing aimed at complying with any legal obligation. I therefore give my consent to the processing of my/our data for the purposes described above in accordance with the privacy lesiglation.

*I declare that I have read the GENERAL PRIVACY INFORMATION

*I DECLARE that there is no impediment to issue the following authorization, taking all responsibility for any possible lack of truthfulness of what is declared, in my name and on behalf of the other parent, or of the person holding parental responsibility over the minor (in the case of a minor); I also declare that I take the responsibility of authorizing the related photographic, video, telematic shooting, interviews and related broadcasts by TV, press, etc.

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

I AUTHORIZE my own (and/or minor's) photographic, video, telematic filming material, interviews and images shared by TV, press, etc.; I also authorize the publication of photos/videos depicting myself and/or my child, on Victoria Languages and Cultures’ website, on paper, digital information material and on our social media channels for marketing purposes, together with the aforementioned photographic, video, telematic and interview footage, of the statements made by myself and/or the minor, as well as my/my child’s name, surname, type of school, age and city, which may be republished in similar services or in contexts that are not harmful to my dignity and that of the minor. I furthermore DECLARE, in my name and on behalf of the other parent, in case of a minor, to waive any consideration that may derive from the publication of said images, statements and personal data of me and the minor. I also DECLARE in my name and on behalf of the other parent, in the case of a minor, that I have nothing to claim from the undersigned Company in any present or future capacity for the above publications. I declare that, in light of the provisions of the Civil Code on parental responsibility (art. 316, 337 ter, 337 quarter), the choice made was shared by the parents.

I authorize what is stated above*
---YESNO

*Permission to Provide Aid: I also hereby give my consent for Victoria Languages and Cultures to provide first aid to our child in case of need.

Date of Compilation gg/mm/yyyy*