Belfast Metropolitan College

Subject Access Request (SAR)

Please note, a separate CCTV Access Request Form should be completed if this is the class of data you require. This form is available on the College Website

Surname: / Former Surname (if relevant):
Forenames: / Tel No: Ext No:
Address: / Date of Birth:
Email Address:
Students Only
Titles of Course/s of Study / Student ID No: / Dates of Study
Staff Only
Job Title and Department / Staff Payroll No: / Dates of Employment

I wish to have access to data that the Belfast Metropolitan College has about me in the following categories: Tick

1 / Academic marks or course work details
2 / Academic or employment references
3 / Disciplinary/Grievance records
4 / Health and medical matters (inc OH Doctors/Nurses Reports)
5 / Political, religious or trade union information
6 / Any statements of opinion about my abilities or performance(including complaints etc)
7 / All recent job application documentation including my application form, and related documents, short listing criteria and notes, interview notes, scoring, ranking & evaluation
8 / Any future correspondence in connection to this SAR from all parties concerned until the satisfactory conclusion of the SAR (including forwarded emails from date of receipt)
9 / Other Information (please specify below)
10 / Please seek the above information from the names listed below: - (specify names please?)

I understand that a fee of £10.00 is payable, and this is enclosed. A Receipt for Payment will be issued.

Signed______Date: ______

Was photographic evidence of identity provided/necessaryYes/No

Signed: ______Date: ______

Corporate Development

Please send/email to:Philip Neill, Corporate Development, Belfast Metropolitan College, Titanic Quarter Campus, TQ-4-17, 7 Queens Road, Belfast, BT3 9FQ or email: Telephone: 028 9026 5047. Your SAR will be acknowledged within 4 working days and responded to within 40 calendar days.

FOR OFFICIAL USE

DPA 1998 – We will respond to you within 40 calendar days from receipt of this SAR

Date
Received / Date
Acknowledged / Date Due / Date Info Received / Info received
From - Initials / Date Info
Sent / Info withheld
Partly/Wholly
Exemption/Reason for withholding information

Jan 2016