Application form for accommodation and use of facilities at the Polish Polar Station Hornsund

    Section 1
    Information about the applicant

    Invoice information
    Company
    Natural person

    Section 2
    Information about person(s) listed in the application for accommodation and use of facilities at the Polish Polar Station Hornsund

    Planned period of stay at the station
    From
    Till

    Section 3
    Information about the planned use of facilities at the station

    Planned use of facilities

    Facilities

    Period

    Planned user (name and surname)


    VHF radiotelephone

    Planned period of use
    From
    Till

    Add another period


    Rifle

    Planned period of use
    From
    Till

    Add another period


    Flare gun

    Planned period of use
    From
    Till

    Add another period


    Other equipment and devices

    Type and quantity

    Planned period of use
    From
    Till

     


    Fuel and oil

    Type and quantity

    Planned period of use
    From
    Till

     

     

    Additional comments:

    Personal data of persons completing the application form are administered by the Institute
    of Geophysics PAS, based in Warsaw, at ul. Księcia Janusza 64. The provision of personal data is voluntary and data subjects have the right to access, rectify or erase their personal data as well as to restrict data processing, object against data processing, withdraw consent for data processing or file a complaint to a data protection controlling authority. The data protection officer of the Institute of Geophysics PAS can be contacted by e-mail at: iod@igf.edu.pl.

    DECLARATION
    According to Art. 6.1(a) of Regulation (UE) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation, OJ.UE.L.2016.119.1 of 4 May 2016), I hereby give consent to the Institute of Geophysics, Polish Academy of Sciences, based in Warsaw at ul. Księcia Janusza 64, to process the personal data I provided during the process of submitting the application form for accommodation and use of facilities at the Polish Polar Station.