Application Form - International Visiting Student
FREE-MOVER

I hereby apply to enrol as a visiting student at Charles University 
Protestant Theological Faculty  
in the academic year: 20__/20__

1) Period of Study: (tick the appropriate box)
Winter Semester (mid Sep – Feb)	 	
Summer Semester (mid Feb – Jun)	 	
Whole Academic Year (mid Sep – Jun)	 	

2) Personal Details:
First name:	Middle name:	
Surname: 
		
Date of birth: 
(DD/MM/YYYY)	Gender:     female         male        	
Nationality: 	Passport number:	
Permanent address (country included): 

Valid address for correspondence (if different from above):

Telephone:	E-mail:	

4) Emergency Contact Person:
Name: 	Relationship: 	
E-mail address:	Telephone:	
Contact address: 

3) Current studies - Home University:
Name of university:	Enrolled since:	Major subject:	Degree program (Bachelor, MA, Ph.D.):	

				
   Which cycle of study are you currently in? (Bc – MA – PhD)		

5) List of courses in which you wish to enrol:

I am interested in enrolling in the following areas of studies:
Department:		
Subjects:		

		

Beware that the offer of courses may change at the beginning and/or throughout the academic year due to limited capacity or unexpected events. In addition, always check the course description for any language or other requirements.

6) Language Proficiency Information:  
Please indicate your knowledge of languages and your level of proficiency.
You should be fluent in English or the language in which you will take courses. Therefore you are required to have at least a B2 level of the relevant language (CEFR levels: https://www.coe.int/en/web/common-european-framework-reference-languages/level-descriptions). 

	Language:			Level:

		

7) Do you wish to be accommodated at a Charles University dormitory? 
	
YES   	NO	

8) Checklist:

   Tick the box if the item has been attached to this application.
CV		
Transcript of records		
Motivation letter		
Study plan		
Letter of recommendation		
Nomination letter from the home university		

9) Information about the processing of personal data:
a)	Personal data controller
The personal data controller is Charles University, Ovocný trh 560/5, 116 36 Prague 1, ID no. 00216208, contact address: Protestant Theological Faculty of Charles University, Černá 9, 115 55 Prague 1 (the “Controller”).
The controller, its employees, and any contractually bound personal data processor have access to the supplied personal data.
b)	Personal data protection officer
Charles University’s personal data protection officer may be contacted at the e-mail address gdpr@cuni.cz.
c)	Scope of processed personal data
The controller will process personal data in the scope supplied in relation to registration for the Exchange study program (hereinafter Program). 
d)	Purpose and legal basis for processing personal data
The controller will process the supplied personal data for the following purposes:
1)	Organization of the program, i.e., program registration, preparation of program materials, issuing receipts, contacting people in relation to the program, including sending a satisfaction survey for improving the provided services relating to the program and resolving any discrepancies or disputes that could arise in this context.
2)	Fulfilling accounting, tax, archival, and similar duties in relation to the relevant institutions or authorities.
3)	Sending e-mail messages for direct marketing, i.e., offering the controller’s products and services, including sending commercial communications.
The legal basis for processing the supplied personal data is the necessity of processing for:
1)	Fulfilling the contract arising between the data subject and the controller upon registering for the program and whose subject matter is participation in the program, including the resolution of any deficiencies or disputes that could arise during fulfilment of the contract; this legal basis is established under Article 6(1b) of Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation) (the “GDPR”);
2)	Fulfilling the legal duties relating to the controller, in particular under:
a)	Act no. 563/1991 Sb., on Accounting, as amended,
b)	Act no. 586/1992 Sb., on Income Tax, as amended,
c)	Act no. 499/2004 Sb., on Archiving and Filing Services and on changes to certain acts, as amended.
This legal basis is established under Article 6(1c) of the GDPR.
3)	The authorized interests of the controller:
a)	The possibility of the effective protection of the controller’s rights during any disputes that could arise as a result of the contract between the data subject and the controller by registering for the program,
b)	Sending commercial communications as set out in Act no. 480/2004 Sb., on certain information society services and on changes to certain acts (Act on Certain Information Society Services), as amended.
This legal basis is established under Article 6(1f) in conjunction with paragraph 47 of the Recitals of the GDPR.
4)	The explicit consent provided by completing the optional information in the program registration form; this legal basis is established under Article 6(1a) and Article 9(2a) of the GDPR.
Hence, except for the optionally completed data, processing is possible even without explicit consent based on the above-stipulated legal grounds. It is completely up to data subjects whether they would like to participate in the program, and therefore, the provision of personal data is not in any way mandatory. However, if the personal data indicated by the controller as mandatory for organizing the program are not provided, it will not be possible to participate in the program.

e)Period of processing personal data

The controller will process the supplied personal data for a period of at least three years after the end of the program, however, no longer than the period during which it is required to perform its duties under law relating to accounting, taxes, filing services, and archiving, or for a period necessary for ensuring the effective protection of controller’s rights when resolving any disputes that could arise in relation to the contract between the data subject and the controller by registering for the program, or for a period based on the rules of the controller of  the program.

f)Transferring personal data
The controller is entitled to transfer the supplied personal data to a third party either based on an agreement on the processing of personal data or in relation to resolving any discrepancies or disputes that could arise during fulfilment of the program agreement.
g)Rights associated with personal data protection
The data subject has the following rights in particular:
1)	The right to request access to personal data and information relating to what personal data are disclosed, in what manner, and to whom,
2)	The right to request deletion of the personal data, if the data subject feels that there are no grounds for processing the data,
3)	The right to request corrections or additions to the personal data, if the data are not precise or complete,
4)	The right to object to the processing of personal data,
5)	The right to refuse the processing of personal data until the legitimacy of an objection or complaint relating to the processing of personal data has been resolved,
6)	The right to request the possibility of transferring personal data to another controller,
7)	The right to submit a complaint to the supervisory authority, which in the Czech Republic is the Office for the Protection of Personal Data (www.uoou.cz).
The data subject may exercise its rights vis-à-vis the controller:
1)	By e-mail with a certified electronic signature sent to the address gdpr@cuni.cz;
2)	Electronically by a data message sent to data box ID piyj9b4.
3)	On paper with a certified signature delivered by a postal carrier service.
Details relating to exercising rights and other rights of data subjects are specified in the GDPR.
h)Additional information relating to the program
As a part of the program, audio, visual, or audio-visual recordings of the program, including photos and verbal discourse of participants, could be made for the media and documentary needs of the controller.

I confirm that the information which I have given in this application is complete and true.

By signing the application form, I confirm that I have been familiarized with the information on the processing of personal data and for optional data and I provide explicit consent to their processing.

Code of study and examination
https://cuni.cz/UKEN-726.html

Declaration
I will comply with the code of study 

Date: _______________________________________________	

Signature: _________________________________________________________________

Note / Comments: