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CONSENT TO USE PERSONAL DATA/INFORMATION

By submitting your details, you are allowing us to use your personal data for the purpose of your
study at the Universiti Teknologi PETRONAS.

The personal data collected herewith is held on and processed by computers situated at
Universiti Teknologi PETRONAS and we will retain the data for a reasonable period or for as
long as the law requires.

We will not disclose any of your personal data collected herewith to any third party except where
you have given us permission to do so or when we are required to do so by law.

If at any time you want to withdraw any permission you have given us to use any part of your
personal data, in any other way, please contact the Registry Department at 05-3688401.



ACKNOWLEDGEMENT

I hereby acknowledge that I have read and understood the above statement and I agree to allow
the university to use my personal data that I have provided for the purpose of my study at
Universiti Teknologi PETRONAS.




Signature:


Name:


Date:





For office use only:

Received by: .. Date:

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