Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 732 views

    Goethe-Zertifikat A2: Fit in Deutsch 2: Exam Registration Form

    Uploaded by

    Hazel Bernardo
    This document contains an exam registration form and consent form for the Goethe-Zertifikat A2 exam to be taken on a specified date at the Goethe-Institut Chicago. It requests the examinee's personal information such as name, date of birth, address, and payment, and includes declarations for the examinee to consent to sharing their personal data with Goethe-Institut headquarters for purposes such as maintaining customer records, administering exams, and sending marketing communications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Goethe-Zertifikat A2: Fit in Deutsch 2: Exam Registration Form

    Uploaded by

    Hazel Bernardo
    732 views2 pages
    This document contains an exam registration form and consent form for the Goethe-Zertifikat A2 exam to be taken on a specified date at the Goethe-Institut Chicago. It requests the examinee's personal information such as name, date of birth, address, and payment, and includes declarations for the examinee to consent to sharing their personal data with Goethe-Institut headquarters for purposes such as maintaining customer records, administering exams, and sending marketing communications.

    Original Description:

    Liste

    Original Title

    A2 fit deutsch

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document contains an exam registration form and consent form for the Goethe-Zertifikat A2 exam to be taken on a specified date at the Goethe-Institut Chicago. It requests the examinee's personal information such as name, date of birth, address, and payment, and includes declarations for the examinee to consent to sharing their personal data with Goethe-Institut headquarters for purposes such as maintaining customer records, administering exams, and sending marketing communications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    732 views2 pages

    Goethe-Zertifikat A2: Fit in Deutsch 2: Exam Registration Form

    Uploaded by

    Hazel Bernardo
    This document contains an exam registration form and consent form for the Goethe-Zertifikat A2 exam to be taken on a specified date at the Goethe-Institut Chicago. It requests the examinee's personal information such as name, date of birth, address, and payment, and includes declarations for the examinee to consent to sharing their personal data with Goethe-Institut headquarters for purposes such as maintaining customer records, administering exams, and sending marketing communications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    GOETHE-ZERTIFIKAT

    A2: Fit in Deutsch 2


    Exam Registration Form
    Exam Date: / /
    Month Day Year

    Price: $70 (please make check payable to the Goethe-Institut Chicago)


    Goethe-Institut e.V.
    150 N Michigan Ave.
    Suite 200
    Title: Chicago, IL 60601
    USA
    Last Name (exactly as on passport):
    Tel: (312) 263 0472
    Fax: (312) 263 0476
    First Name (exactly as on passport):
    language@chicago.goethe.org
    Date of Birth: www.goethe.de/chicago

    Place of Birth (city & state):

    Citizenship:

    Native Language:

    Address:

    City: State and Zip:

    Telephone: Email:

    I hereby confirm that I have read and accept the Exam Guidelines and the
    Terms and Conditions of Exam Administration.

    Date, Place, Signature (parent or guardian in case of minor)


    Declaration of Consent
    Last Name, First Name:

    On executing my signature below, I hereby authorize the Exam Center to transmit and store my
    personal data (“Data”), which I provided under the terms of my registration, in the central customer
    database housed in the headquarters of the Goethe Institute e.V. in Munich, Germany (“GI-HQ”) and
    there to combine this Data with any other Data previously provided and stored there.

    Furthermore, I consent to the use of my Data by the Exam Center and the Goethe Institute for pur-
    poses exceeding those outlined in the executed agreement, namely for market research, advertising
    and any marketing associated with the range of services offered by the Exam Center and the Goethe
    Institute, in particular to send me relevant requests or advertisements (“Information”), such as, but
    not limited to, information about new course offerings at the Exam Center or the Goethe Institute.
    Such Information will be sent to me in the mail using the postal address I provided - and if I stipulate
    - may also be transmitted to me via telephone, fax, e-mail and/or text message (SMS) using the Data
    I have provided. Goethe-Institut e.V.
    150 N Michigan Ave.
    Data concerning the exams I have taken may also be transmitted to the Goethe Institute for sto- Suite 200
    rage and use in the central examination archives (for a maximum period of 10 years) and used for Chicago, IL 60601
    verification purposes and to issue replacement certificates, as required. To the extent that the Data USA
    relates to exams, which entitle my foreign spouse to subsequently immigrate to Germany, I hereby
    authorize the Goethe Institute to confirm, at the request of the German authorities, the authenticity Tel: +001 312 263 0472
    of a certificate I have submitted to a government agency. Fax: +001 312 263 0476

    info@chicago.goethe.org
    Neither the Goethe Institute nor the Exam Center will use my Data for any additional purposes not www.goethe.de/chicago
    otherwise specified in this consent agreement. In addition, neither the Goethe Institute nor the Exam
    Center will provide any Data to a third party, unless there is reasonable suspicion of fraud with
    regard to the Data.

    I have been informed that I may revoke my authorization for my Data’s use for market research,
    advertising and marketing purposes at any time.

    Place, Date, Signature

    Yes, I would also like to receive information via e-mail/ SMS/ telephone/ fax

    Place, Date, Signature

    Right of Revocation
    You may exercise your above-mentioned right to opt out right now or at anytime later in what
    follows:

    • I herewith immediately revoke my authorization for my Data’s use for advertising and marke-
    ting purposes.

    Place, Date, Signature


    Datenschutzeinwilligungserklärung Print PKP

    You might also like