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Examination registration and declaration of consent Details of the examination participant First name: Last name: Street and house number: Postal code and place of residence: E-mail address: Date and place of birth: Gender: male female diverse (Please check the appropriate box) Mother tongue: I hereby register bindingly for the following examination: Exam format: Telc exam Date: Test center: IB Sprachinstitut Stuttgart, Am Wallgraben 100, Stuttgart-Vaihingen Admission written exam: 08.15 am 1. please mark the appropriate test: German test for immigrants following DTZ: I hereby confirm that I the Integration Course Test Ordinance (IntTestV) (https://www.gesetze-im-internet.de/inttestv/BJNR080100013.html), the Integration Course Ordinance (IntV) (http://www.gesetze-im-internet.de/intv/index.html), the organizational information on the DTZ (https://www.telc.net/fileadmin/user_upload/Orgamaterial/01_orga_deutsch-test- fuer-zuwanderer.pdf) Implementation instructions for the DTZ (https://www.telc.net/fileadmin/user_upload/Informationsmaterial/durchfuehrung shinweise_dtz.pdf) and agree with them. Other telc gGmbH exams: I hereby confirm that I am familiar with the examination regulations and the General Terms and Conditions (GTC) of telc gGmbH (https://www.telc.net/agb.html) and agree with them. x https://www.gesetze-im-internet.de/inttestv/BJNR080100013.html http://www.gesetze-im-internet.de/intv/index.html https://www.telc.net/fileadmin/user_upload/Orgamaterial/01_orga_deutsch-test-fuer-zuwanderer.pdf https://www.telc.net/fileadmin/user_upload/Orgamaterial/01_orga_deutsch-test-fuer-zuwanderer.pdf https://www.telc.net/fileadmin/user_upload/Informationsmaterial/durchfuehrungshinweise_dtz.pdf https://www.telc.net/fileadmin/user_upload/Informationsmaterial/durchfuehrungshinweise_dtz.pdf https://www.telc.net/agb.html 1. Data protection: The personal data provided by me as part of my registration may only be used, forwarded and stored within the scope of the retention periods for the purpose of conducting and evaluating the examination and issuing the certificate. 2. Consent: With my signature below, I agree that my personal data may be processed and archived as described above. ___________________________________ Signature Place / Date Data protection information in accordance with Articles 13, 14 and 21 of the EU General Data Protection Regulation 1. name and contact details of the controller and its representative IB Sprachinstitut Stuttgart Am Wallgraben 100 70565 Stuttgart 0711/3654698-11 sprachinstitut-stuttgart@ib.de Examiner responsible: Claudia Tordoya Henckell 2. contact details of the data protection officer Internationaler Bund (IB) Freier Träger der Jugend-, Sozial- und Bildungsarbeit e.V. for the attention of the Data Protection Officer Valentin-Senger-Str. 5, 60389 Frankfurt E-Mail: datenschutz@ib.de 3. the purposes for which the personal data are to be processed The data is used exclusively for the purpose of conducting the audit, evaluating it, communicating the results and archiving it. 4. legal basis for the processing of personal data The data subject has given consent. The legal basis for this is Art. 6 para. 1 lit. a EU General Data Protection Regulation, “hereinafter GDPR”). 5. recipients or categories of recipients of the personal data The type of examination, examination location and date, surname, first name, place and date of birth, gender, native language of the person concerned and, if applicable, postal address and e-mail address are collected as part of the examination registration and administration process. The surname, first name, place and date of birth, gender, native language of the person concerned and, if applicable, postal address and e-mail address are collected as part of the examination registration and administration process. The data is stored at the following IB Group location: IB Sprachinstitut Stuttgart Am Wallgraben 100 70565 Stuttgart 0711/3654698-11 sprachinstitut-stuttgart@ib.de Examiner responsible: Claudia Tordoya Henckell and to the telc gGmbH Basler Straße 7 D-61352 Bad Homburg Phone: +49 69 956 246-10 E-Mail: info(at)telc.net www.telc.net Managing Director Mr. Jürgen Keicher forwarded and saved. The processing of the data takes place jointly with telc gGmbH. 6. origin of the data The data is provided by the test participant. 7. duration of storage Once the check has been completed, the data will be stored for one year by the controller named under point one. mailto:sprachinstitut-stuttgart@ib.de 8. Rights of the data subjects You have a right to information from the controller about the personal data concerning you (Art. 15 GDPR) and, if the corresponding legal requirements for the assertion of the respective right are met, a right to rectification (Art. 16 GDPR), a right to erasure (“right to be forgotten”) (Art. 17 GDPR), a right to restriction of processing (Art. 18 GDPR), a right to data portability (Art. 20 GDPR) and a right to object to processing (Art. 21 GDPR). To assert your rights as a data subject, please contact the data protection officer using the contact details provided above. 9. revocability of consents You have the right to withdraw your consent at any time without affecting the lawfulness of processing based on consent before its withdrawal. Please send your revocation to sprachinstitut-stuttgart@ib.de or by post to the address given above. 10. right of appeal to the supervisory authority You have the right to lodge a complaint with the competent data protection supervisory authority if you believe that your personal data is being processed unlawfully. As a rule, you can contact the data protection supervisory authority of your usual place of residence or workplace or our registered office for this purpose. 11. obligation to provide personal data The provision of personal data is necessary for the performance of the audit to be carried out. 12. existence of automated decision-making including profiling The controller does not carry out automated decision-making, including profiling. mailto:sprachinstitut-stuttgart@ib.de
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