Dear Alumni,

The University, through the Institute for Data and Statistical Analysis, is currently conducting a study on the status of PUP Graduates regarding their employment and professional development. We would therefore like to request your support by answering this Survey Questionnaire. Rest assured that the data that you will provide will be treated in accordance with the provisions of RA 10173 (The Data Privacy Act of 2012).

Thank you,

PUP Research Team

DATA SUBJECT CONSENT FORM PUP TRACER STUDY

I am aware that upon enrollment to the Polytechnic University of the Philippines (PUP), I subject myself to the rules and regulations of the university.

I hereby consent, and authorize PUP to collect, use, disclose, transfer, store, obtain, record, share, update, modify, monitor, and/or process (collectively, “Process/Processing”) my confidential information, personal information, and sensitive personal information as defined under R.A. 10173 “The Data Privacy Act of 2012” and its Implementing Rules and Regulations, and any of its amendments and data privacy and protection (collectively, “Information”), whether manually or in electronic or digital form, all information I have provided in PUP’s forms and/or documents, written or electronic communications, and/or otherwise possessed or collected or gathered by PUP through its own verification and its validation through the public domain, and/or through legally permissible methods and means provided that the same shall only be used for the PUP Tracer Study.

I agree that PUP shall not be liable to me, and that I shall save PUP free and harmless from, and I indemnify the University and its Executive Officials, Directors , Officers, Employees, Agents and Clients for any liabilities, claims, penalties, costs, and expenses of any kind whatsoever, that may be imposed and/or incurred by me relative to, or in connection with the consent and authority to process and/or to the disclosure to such information to the PUP Research Team and such other persons and entities in connection thereto.

By supplying my student number and birthday, I am agreeing to the contents of the above Data Subject Consent Form

(e.g. 2015-00001-MN-0)

(Birthdate Format: yyyy-mm-dd)

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