International Affairs and Corporate Relations Division
Sirindhorn International Institute of Technology, Thammasat University
CONSENT FORM
Date
Topic Student Exchange / Training Program
Mr./Ms./Mrs
I hereby confirm to
❒ Allow
❒ Not allow
the International Affairs and Corporate Relations Division (IACR Division) of Sirindhorn International
Institute of Technology (SIIT), Thammasat University, to collect and disclose personal information for analysis,
allocation, dissemination, and use in relevant and necessary parts of the outgoing student exchange / training program
or activities, for following purposes:
1.
2.
3.
Sending student’s application documents to SIIT’s partner universities both domestically and
internationally to coordinate and facilitate in the application process of student exchange / training
program abroad.
Creating and distributing application result announcement for student exchange / training abroad
program.
Creating promotional materials to publish in communication channels of IACR or SIIT, which may
include my appearance.
However, prior to expressing my intention, I have read the details from a Privacy Notice for users of the
International Affairs and Corporate Relations Division at Sirindhorn International Institute of Technology for the
purpose of collecting, using, or disclosing personal information and have a clear understanding of all details.
I voluntarily give my consent or refuse to consent to this document without coercion or persuasion, and I
know that I can withdraw this consent at any time except in the case of legal restrictions, which will continue to be
notified in writing.
In the case that I wish to withdraw my consent, I acknowledge that not allowing or withdrawing my consent
will result in the International Affairs and Corporate Relations Division, Sirindhorn International Institute of
Technology will not consider my application for the student exchange / training abroad program and will not provide
me with support services. In addition, I will not be able to sign up for activities organized by IACR.
I am aware that the withdrawal of such consent does not affect the processing of personal data that has been
completed prior to the withdrawal of consent.
(Signature) ……………………………….…………………………
(…..………………………………………………………...)