Subject Access Request Form

Section 1. Personal Details

Under the General Data Protection Regulation (GDPR), you as a Data Subject have specific rights in relation to your personal data that is being processed and stored by MIC. To exercise this right, please complete this form and provide adequate proof of identity.

1. First Name

2. Surname

3. Address

4. If you have not lived at the above address during your association with the College, please provide a previous address:

5. Daytime Phone Number

6. Email Address

8. If you are/ were a student at MIC/ member of staff, please provide your Student ID number or the department you worked in.

Section 2. Data Requested

10. Description of Request

Section 3: Declaration

I certify that the information provided above is correct to the best of my knowledge. I also understand that the College is obliged to confirm proof of identify/authority and it may be necessary to obtain further information in order to complete this request.

Agree

When you submit this form, it will be automatically sent to the Information Compliance Office at MIC. If you have any questions about the form, you may contact the Information Compliance Office at the email address DataProtection@mic.ul.ie.

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Section 1. Personal Details

Section 2. Data Requested

Section 3: Declaration

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