International Teachers and Educators Program 2023 APPLICATION FORM
Thank you for your interest in the Pilecki Institute program for teachers and educators. This years' edition of the program will take place online between 12 and 14 of May (3 conference days).

Please fill in the following form to submit your application.

The ITEP Coordination Team will contact each applicant to inform about the results no later than on April 28, 2023.

Sign in to Google to save your progress. Learn more
Email *
Name *
Surname *
Nationality *
City of residence *
Country of residence *
I work as a: *
Required
Years of experience in education *
I am an active professional: *
Place of employment *
Level of English: *
What do you expect from the Pilecki Insititute International Teachers and Educators Program? *
What are your main fields of interest? *
What book would you recommend us and why? *
Short professional bio *
How did you learn about ITEP? *
If qualified, I declare taking part in the full e-learning seminar (3 conference days between 12–14 V 2023) *
Pursuant to the provisions of Article 13, Subparagraph 1 of the Regulation (EU) 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), hereinafter referred to as “the Regulation”, we hereby inform that the controller of your personal data shall be the Witold Pilecki Institute of Solidarity and Valor with its seat at Foksal Street 17, 00-372 Warsaw.2. Pursuant to currently valid legal provisions, we have designated a Data Protection Officer, who may be contacted: • by mail at the address: Instytut Solidarności i Męstwa im. Witolda Pileckiego, ul. Foksal 17, 00-372 Warszawa,• by e-mail: iodo@instytutpileckiego.pl;3. Personal data obtained in connection with the conclusion of the Contract with yourself shall be processed for the following purposes:• connected with the performance of the Contract signed by yourself,• connected with the pursuit of possible claims or damages,• responding to your letters, proposals, motions and complaints,• providing responses under proceedings pending.4. The following shall constitute the legal basis for the processing of your personal data:• processing shall be necessary for the performance of the Contract or in order to take steps at your request prior to entering into the Contract (Article 6, Subparagraph 1, Letter b of the Regulation),• processing shall be necessary for ensuring compliance with a legal obligation to which the controller is subject (Article 6, Subparagraph 1, Letter c of the Regulation),• processing shall be necessary for the purposes of the legitimate interests pursued by the controller (Article 6, Subparagraph 1, Letter f of the Regulation).5. The provision of personal data is voluntary, however it is required for the purpose of concluding and performing the Contract.6. The personal data obtained from yourself may be submitted to:• data processors processing personal data upon our instruction, and• public bodies and entities authorized to obtain personal data on the basis of currently valid legal provisions, for example courts of law, law enforcement agencies, or state institutions, whenever these so request pursuant to a relevant legal basis.7. Your personal data shall not be transferred to third countries.8. The period for which your personal data shall be processed will depend on the purpose for which the data are processed. The period for which your personal data shall be processed will be calculated on the basis of the following criteria:• term of the Contract,• provisions of law that may obligate us to process personal data for a specified period of time,• the period necessary to defend our interests.9. Furthermore, we would like to inform that you are entitled to:• access your personal data,• request the correction or supplementation of your personal data if the said are inaccurate or incomplete, respectively,• request the removal of your personal data, in particular if you withdraw your consent to processing, when there is no other legal basis for processing,• request that the processing of your personal data be restricted,• lodge an objection against the processing of your personal data, this on the grounds of your particular circumstances, if we conduct the processing of your personal data on the basis of our legitimate interests, or for the purposes of direct marketing,• transfer your personal data,• lodge a complaint with the personal data protection supervisory authority, i.e. the President of the (Polish) Personal Data Protection Office (Prezes Urzędu Ochrony Danych Osobowych).10. To the extent that your data are processed on the basis of consent provided by yourself, you shall be entitled to withdraw such consent at any time. Your withdrawal of consent shall not affect the legality of processing performed on the basis thereof prior to said withdrawal. You may withdraw your consent by sending a declaration informing of your withdrawal of consent to either our correspondence or email address.11. We would further like to inform that we do not employ automated decision-making systems. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Instytut Solidarności i Męstwa im. Witolda Pileckiego. Report Abuse
Google Forms