I am the parent/guardian of _________________________________________ who is enrolling as a student of DMMC INSTITUTE OF HEALTH SCIENCES, I am giving consent for DMMCIHS to collect and process my daughter/son’s personal data in relation to her/his enrollment to DMMCIHS.

         The DMMCIHS is committed to protecting the privacy of information we create or receive about your child/ward. It is the mandate of the law, that we, as collectors and processors of information, shall make sure that information (personal, sensitive or privileged) is protected and kept, unless certain exceptions will apply. DMMC-IHS through its employees or through authorized third parties may collect, use, process data and information about your child/ward over the course of interactions/transactions. Furthermore, we assure you that we enforce and comply with Data Sharing Agreement as mandated by the Philippine Data Privacy Act of 2012.

         By signing below, I warrant that I have read and understood the following provisions and agree with their full implementation.

1. Republic Act No. 10173, or the data Privacy Act (DPA) of 2012, and other relevant Philippine laws apply to collection and processing of my duaghter’s/son’s personal data. “Personal data refers to all types of personal information “whether recorded in a material form or not from which the identity of an individual is apparent or can be reasonably and directly ascertained by the entity holding the information, or when put together with other information would directly and certainly identify an individual.” (NPC Advisory No. 207-01).
 
2. I understand that in enrolling my daughter’s/son’s at DMMCIHS, I am allowing DMMCIHS to collect, use, process and share my daughter’s/son’s personal data where a legitimate educational or institutional interest exist in its determination, including academic, administrative, historical and statistical purposes. Personal data includes my daughter’s/son’s personal circumstances and directory information such as – but not limited – demographic profile, contact details like address, landline/mobile numbers, email address, previous school attended and academic standing, disciplinary record, family background which includes employment status and of parent and/or guardian. As a student, information will also be collected on my daughter’s/son’s academic performance (grades in exams, recitation, homework, etc), the classes she/he enrolls in, the clinical practicum, practice teaching, on the job training, attendance record, information for and in relation to her/his co-curricular and extra-curricular activities such as outreach activities, membership in student organizations, leadership positions and participation and attendance in seminars and competitions among others. The personal data may be written form, pictures or videos, recording from closed-circuit television (CCTV) cameras installed in the DMMCIHS campus for security purposes or other forms.
 
3. The personal data of my daughter’s/son’s will be accessed and used by DMMCIHS and the personnel of the unit/office concerned who has a legitimate interest it for the purpose of carrying out their official duties.
 
4. The purposes for which DMMCIHS may share or disclose the personal data of my daughter’s/son’s include among others, publishing academic, co-curricular and extra-curricular achievements and success, including honors lists and names of awardees in school bulletin boards, website, social media sites and publications; the promotion of the school, including its activities and events, through photos, videos, brochures, website posting, newspapers advertisement, physical and electronic institutions, companies, government agencies, public or private corporations or the like, upon their request with scholastic ranking information for purposes or student exchange, apprenticeship placements.
 
5. Unless otherwise provided by law or by appropriate school policies, the personal data of my daughter’s/son’s will be indefinitely retained for historical and statistical purposes. Where a retention period is provided, all records after much period will be securely disposed of. The physical document collected are stored in some secured place and only authorized personnel are given the authority to access the data.
 
6. Under the DPA 2012, the data has the right, among others, to be informed of the processing of her/his data, reasonable access to the personal information upon demand, correct, withdraw or order the blocking, removal or destruction of her or his personal information on grounds indicated therein.
 
7. By providing personal data to DMMCIHS, I am confirming that data is true and correct. I understand that DMMCIHS reserves the right to revise any decision made based on the information I provide should the information be found to be untrue and incorrect.
 
8. Any issue that may arise in connection with the processing of the personal information will be settled amicably with the institution before resorting to the appropriate arbitration or court proceedings with in the Philippine jurisdiction.

         I have read this form, understand its contents, and consent to the processing of my daughter’s/son’s data. I understand that my consent does not preclude the existence of other lawful processing of personal data and does not waive any of my rights under the Data Privacy Act of 2012 and other applicable laws.

SHS/COURSE/PROGRAM:
SIGNATURE OF PARENT/GUARDIAN:
PRINTED NAME OF PARENT/GUARDIAN:
DATE:
Witness:
____________________________________	____________________________________
Signature Over Printed Name	Date