Republic of the Philippines
GENERAL SANTOS CITY
SCHOOL OF GRADUATE STUDIES
DATA PRIVACY CONSENT FORM
Pursuant to the provisions of the Data Privacy Act of 2012 and the Data Privacy Notice for Students of
MSU-GSC, School of Graduate Studies, you hereby confirm and acknowledge, by signing your name
below, that you and/or next of kin/legal representative freely and voluntarily give consent to the
collection and processing of your data, which may include personal information and/or sensitive
information such as birth date, address, sex at birth, gender identity, contact information set out in the
MSU-SGS forms.
The MSU-SGS shall use the Data for your academic engagements in the university. With this purpose,
the MSU-SGS may disclose your personal and/or sensitive information to people involved in your
academic-related activities to other third parties where required or permitted by law or contract,
including regulatory authorities and other agencies of the Government.
Moreover, your personal information and/or sensitive information may also be processed by the MSU-
SGS for use for the following: research and education, profiling, historical or scientific purpose, and
also to generate statistics relevant to the institution’s operations and financial performance.
The MSU-SGS shall preserve the Data throughout the term of engagement between you and the
institution, and for as long as necessary, for the intention of maintaining your records and to comply
with applicable laws, rules, and regulations. It is understood that you are entitled to certain rights
concerning the Data collected from you and/or your next of kin/legal representative, including the
right to object to the processing of the Data, the right to access it, the right to rectify any inaccuracies
in the Data, and the right to erasure or blocking of the Data. You may consult with our SGS- Data
Privacy Officer (DPO), Jesus C. Managa or the University DPO, Laiza L. Limpin, for any concerns
regarding the Data. Your consent shall remain valid and in force and effect until you revoke the same
in writing, and which revocation is duly addressed and received by the MSU-SGS DPO.
Conforme:
___________________________________
Printed Name Over Signature
Date:_____________
