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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Job title

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* 6. In what city/town do you work?

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* 7. What region are you from?

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* 8. For which Court or Organisation do you work?

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* 9. What is your gender?

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* 11. To achieve your Certificate of Completion the weekly workload is approximately 2 – 3 hours over the 5 weeks including engaging in the online Discussion Forum and attending one live online session a week. Most of the training can be done in your own time and space. Are you prepared to commit to this?

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* 12. What are your motivating factors for undertaking this course?
(Tick more than one if you wish.)

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* 13. Are you a member of the Central and Eastern European Judicial Exchange Network?

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* 14. How did you hear about this event?

We thank you for your interest in this program. Your application will now be reviewed and we will be in touch in early September with confirmation and with further information on the course.
If you have any further queries or suggestions please contact Marcela Entlichova at marcela.entlichova@ceeli.eu
GDPR

By filling in this form, You hereby, pursuant to Article 6 (1) (a) of the Regulation (EU) 2016/679 of the European Parliament and of the Council, General Data Protection Regulation (hereinafter as “GDPR”), as amended, give a consent to the processing of Your personal data. This consent is explicit in order to meet the requirements pursuant to Article 9 (2) (a) of the GDPR the data could in specific cases be considered as sensitive (special categories of) personal data - data concerning health, etc.
Due to the fact that Your future participation in the above mentioned event establishes a contract (including oral) with the below listed controller, the legal basis under Article 6 (1) (b) of the GDPR, thus “to take steps at the request of the data subject prior to entering into this contract”, may also be considered as the basis for the processing of Your personal data.

The controller of Your listed personal data is CEELI INSTITUT, o.p.s., reg. number: 26167379, with its registered office: Havlíčkovy sady 58, 120 00 Prague, contact e-mail: office@ceeli.eu (hereinafter as “Controller.”)

Further, you hereby give an explicit consent to the organizer of the event and Controller to take photo- and videorecordings of me during the event and to their subsequent use for the purpose of processing reports for sponsors of the event and in the promotional materials of the organizer, including printed annual materials and presentations published on the internet including organizer’s social media profiles.

Other information related to the processing of Your personal data (pursuant to Article 13 of the GDPR).

• The purpose of the processing is to arrange and otherwise administer Your participation in the events held by the Controller. The provision of Your personal data is a requirement necessary to enter into the above mentioned contract without which it is not possible to enter into it and to attend to the events held by the Controller.
• This consent is granted for an indefinite term. Thus Your personal data will be stored for the indefinite period of time.
• Categories of recipients of Your personal data: Controller and other persons cooperating with Controller on his activities, The provider of services of ticket purchase.
• Your rights concerning the processing of Your personal data: You may withdraw the consent at any time in which case the processing based on the consent before its withdrawal is not be affected. You may request the controller for the access to Your personal data and for their rectification or erasure or restriction of processing concerning Yourself, all under the conditions laid down in the GDPR. You may also object to processing at the Controller. You have the right for Your data to be portable. You may lodge the complaint with the Office for Personal Data Protection, with its registered office: Pplk. Sochora 27, 170 00 Prague 7.

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