Consent 
of an employee of National Research Tomsk Polytechnic University (hereafter TPU or Operator) to process personal data by the Operator located at 634050, Tomsk, Lenin Avenue, 30

Last name: _______________________________________________________________________________________
First name: _________________________________________________________________________________
Middle/Patronymic name: _____________________________________________________________________
Home address: ________________________________________________________________________________
Passport: number__________________________ Date of issue________________________________________
Issuing authority ____________________________________________________________________________
Herewith I consent to processing the following personal data:

General information
•	Last name, first name, middle/patronymic name, date of birth, place of birth, citizenship, education, professional occupation, information on family members, passport details;
•	Home and/or mobile number;
•	Current position;
•	Total length of employment;
•	Research and teaching experience;
•	Previous employment;
•	Qualification and work experience;
•	Academic degree; 
•	Academic title;
•	Education level, diploma qualification;
•	Advanced trainings and professional retraining;
•	Document details on professional retraining, certification, assessment and education;
•	Teaching courses;
•	Areas of teaching;
•	Business phone number;
•	Home address;
•	Business e-mail;
•	Information on salary;
•	Information on social benefits;
•	TIN;
•	Insurance certificate;
•	Information on work record book;
•	Content of Labor Contract and Extensions to Labor Contract;
•	Content of tax declaration to the tax office and RF Ministry of Education and Science;
•	Awards;
•	Diploma nostrification;
•	Foreign languages level;
•	Criminal history;
•	Military service registration;
•	Results of medical checkups;
•	Photographs;
•	Orders on employment, transfer and retirement;
•	Personal record data on the forms T1 and T2;
•	Other personal data can be used by the Operator to create a valid documentation for concluding my employment contract with the Operator.

Special information on personal data:
•	Physical condition (results of health examination must be satisfied to perform of employment duties);
•	Nationality
Biometric personal data
•	Color photograph

I consent to using my personal data by the Operator to create a valid documentation for concluding my employment contract with the Operator, to ensure a correct performance of my employment duties, provide information to RF authorities in the manner prescribed by legislation, as well as to provide information to medical institutions and insurance companies, to ensure me with a social package.
This consent is given to perform any actions regarding my personal data, which are required or desirable to achieve above-mentioned purposes.
Herewith I further authorize Tomsk Polytechnic University to use the above data in its daily activity and for informative purposes (telephone book, information on the TPU web-site, preparation of reports and submission of information upon inquiries both inside and outside the university including (without limitation) to collect, systematize, accumulate, store, detail (amend, change), use, depersonalize, block, transmit the data and perform any other actions under the RF legislation.
The Operator guarantees that processing of my personal data conforms to the stipulations of the RF legislation and Regulation on Protection of Personal Data of TPU Employees which I have read and understood during employment to TPU.

This consent is valid for the duration of the term of my contract with TPU (Operator). 
I confirm that present consent is given on my own will and in my interests.
This consent may be revoked by me by a written notice.

(signature)				(full name)					(date)