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)

Inflatable boat with engine
Planned period of use
From
Till

Add another period

Aluminium boat with engine
Planned period of use
From
Till

Add another period

Snowmobile with sled
Planned period of use
From
Till

Add another period

220V portable generator
Planned period of use
From
Till

Add another period

VHF radiotelephone
Planned period of use
From
Till

Add another period

Rifle
Planned period of use
From
Till

Add another period

Shotgun
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

 


Cartridges

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.