Ref code: VFFD8784 | 2024 | Uzbekistan Business Leaders Consent American Councils Informed Consent

Consent Forms
Do you currently live in Uzbekistan?
Yes No
What is your date of birth?
1993-02-12
Corporation American Councils for International Education Uzbekistan (“American Councils Uzbekistan”, “we”, “us”, or
“our”) based at Grand Business Center #304, 12 Sh. Rustaveli, Yakkasaray Tashkent, Uzbekistan, would like to inform you about the
Uzbekistan Business Leaders (“the program”) program. To participate in the program, American Councils requires certain data
about you. Your written consent is required to continue with your application.

What Is the Uzbekistan Business Leaders Program?

The Uzbekistan Business Leaders program will bring business leaders from Uzbekistan aged 27-50 to the United States to participate
in professionally relevant, and tailored to their interests four-week fellowships at a wide variety of for-profit and non-profit
organizations, university business departments, accelerators, and relevant government economic development offices. It will provide
participants with an array of modern business tools, concepts, and principles that will strengthen their leadership and technical
abilities through interactive and personalized projects, and build enduring professional relationships between Americans and people
of Uzbekistan who share an interest in driving economic development forward.

What Data Will Be Collected, Used, and Stored?

For this program, your personal data will be collected, used, and stored. Different data is collected at the applicant, finalist, and alumni
stages.
At the applicant stage, you may be asked to share:
▪ Demographic data, such as name, email address, telephone, address, birth date, and citizenship
▪ International travel and exchange program experience
▪ Educational data, such as school enrollment details, or employment data
▪ Other data of your choice, such as awards and accomplishments, and disclosure of disability

At the finalist stage, you may be asked to share:

▪ Details about mental, physical, and dental health data, such as height, weight, health history, vaccination records, dietary
restrictions, and physical limitations
▪ RA passport data and copy

At the alumni stage, you may be asked to share:

▪ Demographic data, such as place of residence
▪ Educational data, such as university enrollment
▪ Occupational data, such as employment information
▪ Other data of your choice, such as awards and accomplishments

Why Is this Data Required?

Your personal data is required for the following purposes:
At the applicant stage:
▪ Initiating participation in the application process

At the finalist stage:

▪ Providing on-program support to the finalist
▪ Offering additional on-program opportunities to the finalist

At the alumni stage:

▪ Engaging the alumni in alumni programming

Why Might Third Parties Have Access to My Data?

Some examples of why we may provide your personal data to third parties are:
▪ Sending you program preparation materials
▪ Arranging transportation, to and from your program location

Page 1 of 2
Ref code: VFFD8784 | 2024 | Uzbekistan Business Leaders Consent American Councils Informed Consent

▪ Arranging your participation in conferences, seminars, and other similar activities

▪ Evaluating any health and medical information that you provide to us
▪ Providing support to you while you are on program
▪ Contacting you about post-program alumni activities
▪ Generating aggregated and anonymized statistical reports that may be shared with program funders

Additional Information
For additional information about how and why we collect, use, and store your personal data, please visit our About Your Data page.

Your Consent Decision

Consent for the Collection, Use, and Storage of Personal Data
Applicant
I consent to the collection, use, and storage of my personal data in the way and for the purposes described in this Informed
Consent. Indicate your decision:
Yes, I consent No, I do not consent
Date of Consent
Nov 09, 2023
Applicant's Signature
Muhriddin Fayziyev
Consent for the Transfer of Personal Data Outside Your Country or the European Economic Area (the “EEA” consists of
all EU Member States, plus Iceland, Liechtenstein, and Norway)
Applicant

▪ I consent that my personal data be transferred to the United States of America (“USA”) and, on a limited basis, to
other countries outside of my country of residence or the EEA.
▪ I understand that the standard protections afforded to those in my country or the EEA may not fully apply to data
that I voluntarily consent to be transferred to the USA or other countries outside of my country or the EEA.

Indicate your decision:

Yes, I consent No, I do not consent
Date of Consent
Nov 09, 2023
Applicant's Signature
Muhriddin Fayziyev

Page 2 of 2