Application form for accommodation and use of facilities at the Polish Polar Station Hornsund Posted on July 22, 2022 by Dagmara Bartniak Section 1 Information about the applicant Name (required) Surname (required) Name of institution (required) Email address (required) Telephone number Invoice information Company Natural person Company name: Company address: Tax identification number: Name and surname: Address of residence: Section 2 Information about person(s) listed in the application for accommodation and use of facilities at the Polish Polar Station Hornsund Name (required) Surname (required) Name of institution Email address (required) Source of funding (name of project / grant / research, etc.) RiS number Planned period of stay at the station From Till Add another person APPLICATION FOR ANOTHER PERSON Information about person(s) listed in the application for accommodation and use of facilities at the Polish Polar Station Hornsund Name (required) Surname (required) Name of institution Email address (required) Source of funding (name of project / grant / research, etc.) RiS number Planned period of stay at the station From Till Add another person APPLICATION FOR ANOTHER PERSON Information about person(s) listed in the application for accommodation and use of facilities at the Polish Polar Station Hornsund Name (required) Surname (required) Name of institution Email address (required) Source of funding (name of project / grant / research, etc.) RiS number (required) 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 Planned period of use From Till Add another period Planned period of use From Till Rifle Planned period of use From Till Add another period Planned period of use From Till Add another period Planned period of use From Till Flare gun Planned period of use From Till Add another period Planned period of use From Till Add another period Planned period of use From Till 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.
