GDPR - Request for Personal Data Deleted

Section 1 - Applicant Details

Name

First

Last

Previous Family Name:

Other name(s) known by:

DOB

Place of Birth:

Section 2 - Applicant Details

Address

Zip/Postal

City

Country

Daytime Phone No:

Email

Section 3 - Proof of the applicant's identity

To prove the applicant’s identity, we need to see copies of two pieces of identification, one from list A and one from list B below. Please indicate which ones you are supplying.

Please DO NOT send an original passport, driving licence or identity card

List A (photocopy of one from below)

List A Upload

Maximum file size: 2.1MB

List B (plus one original from below)

List B Upload

Maximum file size: 2.1MB

Section 4 - Details of the request to erasure

Please use this space to give us any details about the information you are requesting, for example by stating specific documents you require (use extra sheets if necessary):

Section 5 - Declaration

The information which I have supplied in this application is correct, and I am the person to whom it relates or a representative acting on his/her behalf. I understand that Derby College may need to obtain further information from me/my representative to comply with this request.

Please tick the box below

Signature of Applicant

reCAPTCHA

GDPR – Request for Personal Data Deleted

Section 1 - Applicant Details

Section 2 - Applicant Details

Section 3 - Proof of the applicant's identity

Section 4 - Details of the request to erasure

Section 5 - Declaration