Berklee Students Required Information

Berklee College of Music, Delegación de la Fundación en España (hereinafter, “Berklee Valencia”) needs the following information for administration and emergency purposes during the Program you will be attending. Complete this form as soon as possible.

Student ID

Berklee Student ID Number. For example: 0876543

First / Given Name

Exactly as appears on your passport or ID card.

Last / Family Name

Exactly as appears on your passport or ID card.

Preferred Name

The name you’d prefer we use if it differs from your first / given name

Personal Email Address

Berklee Email Address

If you have your Berklee email address, enter it here.

Phone Number

Phone

What sex were you assigned at birth on your original birth certificate?

This information is collected for the purposes of your health insurance registration. If you choose not to disclose, we might need to reach out to you directly for this purpose

Date of Birth

mm/dd/yyyy

Birth Place

State/Province and Country

Nationality

If you hold citizenship in more than one country, list the country whose passport/EU identity card you will use to enter Spain.

Home Address

Please add your full home address, including postal code.

Repatriation Country

In order to comply with legal requirements, your health insurance covers repatriation due to accidents or sudden illness. Please add your country of origin for repatriation.

Student Visa

ID Type

Passport

National ID

Passport # or National ID #

We know at this point you might not have your passport issued. Please remember that we need your Passport ID# or National ID# to formalize the health care insurance process. Send it to us as soon as you have it. In case you have your visa already stamped, please upload that page.

We need from you a scanned copy of your passport or ID card as well as your VISA stamp if you have it (see example: http://bit.ly/1FD76ii) Files must be uploaded in .PDF format only and named with your Berklee ID number. For example, 087654.pdf Files with different formats and/or named incorrectly will be rejected. File Uploader. Upload your passport here.

Drop your files here

Passport/ID Expiration Date

mm/dd/yyyy

Passport Issue Date

mm/dd/yyyy

Confirmed arrival date in Valencia

If known.

mm/dd/yyyy

Travel Information

If known. For example: Flight number / flight / train combination...

Family Members Coming to Spain

Who from your family will accompany you to Spain?

Emergency Contact Information

Should an emergency situation occur or should I get seriously hurt or suffer a serious disorder or disease during my participation in the Program which might prevent me from taking conscious decisions, and / or I am considered missing; I hereby authorize both Berklee College of Music and its subsidiary Berklee College of Music Delegación de la Fundación en España and their staff to notify the individual listed on the Emergency Contact form.

I DO authorize the following individual to be notified.

First and Last Name (Emergency Contact)

Relationship to you?

Is this person your mother/father, brother/sister, husband/wife, friend, etc.

Country Code + Phone Number (Emergency Contact)

Email Address (Emergency Contact)

I hereby guarantee that I have obtained prior and express consent for this assignment of personal data from third parties according to requirements set forth in legal provisions in force and that I am therefore legally entitled to assign such personal data to you.

Image Rights Release

As you already know, recording your image and sound is an essential way to learn in the music field.

When you decide to join Berklee Valencia, it is important to acknowledge that you have the possibility to accept that your image and sound may be captured and used for educational, informational, and general advertising purposes.

In that case, you'll have the chance to be featured on our official channels and be recognized by our entire community. This is an excellent opportunity to gain exposure, build your portfolio, and showcase your creativity to the world.

PLEASE READ THE BELOW DOCUMENT CAREFULLY

CIVIL PROTECTION OF THE RIGHT TO HONOR, PERSONAL

AND FAMILY PRIVACY AND LIKENESS

(ORGANIC LAW 1/1982 OF 5 MAY, ON CIVIL PROTECTION OF THE

RIGHT TO HONOR) AND INTELLECTUAL PROPERTY PROTECTION

(ROYAL LEGISLATIVE ACT 1/1996, OF APRIL 12, 1996,

APPROVING THE REVISED TEXT OF THE INTELLECTUAL

PROPERTY LAW)

PLEASE CHOOSE ONE OF THE FOLLOWING:

Select one of the following:

Personal Data Protection

The processing of information shall be subject to the provisions the General Data Protection Regulation 2016/679 and the Spanish Organic Law 03/2018 on Protection of Personal Data.

The controller in charge of processing your personal data

Berklee College of Music Inc. with registered office at 1140 Boylston Street / Boston, MA 02215 USA and its branch Berklee College of Music, Delegación de la Fundación en España, at Avenida del Profesor López Piñero, 1, Palau de les Arts-Anexo Sur / Valencia (CP 46013), España, assigned Tax Identification Number (NIF) G98483779; with e-mail address dpo@berklee.edu (hereinafter referred to as “Berklee”); will collect and process your personal data.

Purpose of processing

Berklee will collect and process your personal data for the management of the onboarding and administrative processes and, where appropriate, the subsequent execution of the pre-contractual relationship with Berklee. Also, in extraordinary circumstances, emergency contact information may be needed as part of the emergency management plans within the institution.

The legal basis for processing

Your data will be processed pursuant to your consent.

You have the right to withdraw consent at any time, without affecting the lawfulness of processing based on consent before its withdrawal. Interested parties who do not allow their personal data to be processed may not be able to join any academic program in Berklee.

Communication of personal data

Third parties will only have access to the personal data if Berklee is legally required by law, or when it is strictly necessary to execute a service contract between Berklee and third parties. Retention of personal data that is provided through the present form will be processed during the time the Summer Program is active. Once the Summer Program is terminated the data will be duly blocked so long as legal liabilities may derive for the party. It is your responsibility to provide reliable data to Berklee and keep this information updated.

How interested parties may exercise their rights

Pursuant to the applicable legislation, Berklee is committed to respecting the confidentiality of its users’ personal data and to ensuring that interested parties may exercise, at any time and in the terms set forth by the legislation in force. You may exercise the rights of access, rectification, erasure, limitation of processing, opposition, portability, withdrawal of consent and not to be subject to automated decisions, by sending a written request clearly indicating the right they would like to exercise, and sending it to the following address: Berklee College Of Music, Delegación de la Fundación en España / Re.: Information Protection Rights / Avenida del Profesor López Piñero, 1 (Palau de les Arts-Anexo Sur), 46013, Valencia, or by e-mail to the address dpo@berklee.edu. You may also file a complaint with the Spanish Data Protection Agency.

Contact

You may contact Berklee’s data protection officer at the following address: dpo@berklee.edu.

I DO consent.

Send me a copy of my responses

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