Subject access request form

Title (Mr, Mrs, Miss, Ms)
Other Title (Professor, Dr, Rev, etc.)
Name

First name

Last name
Your relationship with the University of Birmingham. Please state if you are a current or former member of staff or student
Staff or student ID number (if applicable)
Date of Birth
Address

Address Line 1

Address Line 2

City

County

Postcode

Country
Email
Please describe the personal data you are requesting.
Where is the data likely to be held within the University?

Please give an indication of: • Each College/School/Department or Corporate Service which you believe is likely to or may hold your data • Which individuals at the University are likely to hold your data
Do you wish to access papers held by Occupational Health?
Do you wish to access emails that you believe contain your personal data that are being held by members of the University? If so, please provide the names of these individuals
Please provide any key words or phrases, other than your name, to be searched against.
Requests for access to CCTV images must include:- a) The date and time the images were recorded b) Information to identify the individual, if necessary c) The location of the CCTV camera d) Photographic proof of Identity

Colleges