Panelist Consent Form

1. Consent to the Collection and Use of Personal Information

(1) Purpose of Collection and Use of Personal Information
The Korean-American Educational Commission (hereinafter referred to as the "Commission") collects and uses personal information for the following purposes.
1) Administration of Fulbright Grant Programs
- Confirmation of panelist information related to application evaluation, identification of individuals, delivery of evaluation guidance, payment of honorarium, etc.
2) Fulbright Grant Program Panel Management
- Appointing Panelists, providing panelists’ information to affiliate or external organizations, etc.
(2) Personal Information to be collected 
1) Administration of Fulbright Grant Programs
Name (Korean/English), Copy of Identification, Date of Birth, Resident Registration Number (Unique Identifier), Gender, Nationality, Email, Contact Information (Home, Work, Mobile), Current Workplace Information, Residence, Resume/CV, Educational Background (School, Major), Work Experience, Fulbright Grant Recipient Information
2) Fulbright Grant Program Panel Management
Name (Korean/English), Gender, Nationality, Email, Contact Information (Home, Work, Mobile), Current Workplace Information, Resume/CV, Educational Background (School, Major), Work Experience, Fulbright Grant Recipient Information 
(3) Retention and Use of Personal Information 
The validity of this consent form remains effective even if the corresponding Fulbright Grant Program activities are renewed or modified. Personal information will be retained and used until the intended purposes are achieved. 
(4) Consent to Collection and Use 
You may refuse to consent to the collection and use of the above personal information; however, if you do not consent, you may not be able to serve as a panelist.

I have fully understood the above and agree with the collection and use of my personal information by the commission as described above.

1. Purpose of Collection and Use of Personal Information *

I consent
I do not consent

2. Consent to Provision of Personal Information to Third Parties

The Commission provides the personal information listed in section 1. (2) above to the following third parties for the following purposes. The third parties will retain and use the personal information for the period necessary to achieve the intended purposes.
(1) Provided to the agency managing the necessary administrative documents for the disbursement of honorariums to panelists.
(2) Provided upon request for internal use by any of the following organizations: U.S. Department of State, Institute of International Education (IIE), IIE partner organizations (Study Colorado, World Affairs Council, San Diego Diplomacy Council, etc.), World Learning, and the U.S. Embassy in Korea.
(3) Provided upon request to the Korean Fulbright Alumni Association and affiliate organizations 
(4) Provided to external agencies when requested, information regarding grant programs for which panelists have participated in applicant evaluations.
(5) Provided to investigative agencies or courts upon request, in accordance with the procedures and methods mandated by law for investigative purposes.
(6) Provided to the National Assembly if requested for the purpose of personnel hearings or national audit and investigation in accordance with the Personnel Hearing Act or the Act on National Audit and Investigation.
(7) Provided in the case of specific provisions in the law or unavoidable circumstances requiring compliance with legal obligations, information shall be provided to comply with the law and to third parties as prescribed by law.

You may refuse to consent to the disclosure of the above personal information to third parties, but if you do not consent, you may not be able to serve as a panelist.

I have fully understood the above and consent to the provision of my personal information to third parties as described above by the commission.

2. Consent to Provision of Personal Information to Third Parties *

I consent
I do not consent

3. Consent to the Provision of Personal Information to Third Parties outside of Korea

3. Consent to the Provision of Personal Information to Third Parties outside of Korea *

I consent
I do not consent

4. Consent to Processing of Uniquely Identifiable Information

4. Consent to Processing of Uniquely Identifiable Information - 1 *

I consent
I do not consent

4. Consent to Processing of Uniquely Identifiable Information - 2 *

I consent
I do not consent

Name (Korean)

For Korean panelists only

Name (English) *

Date *

Signature *

Clear Signature

Panelist Information

Program *

Gender *

Employer *

Program Year *

Mobile *

Department *

Name *

Primary Email *

Title *

Date of Birth *

CV *

Click or drag files to this area to upload. You can upload up to 2 files.

doc(x) or pdf

Fulbright Alumni Information

Are you a Fulbright Alumni?

Are you a Fulbright Alumni? *

Yes, I am an Alumni.
No, I am not an Alumni.

Past Fulbright Evaluation Experiences

Do you have experience participating in past Fulbright program evaluations?

Do you have experience participating in past Fulbright program evaluations? *

Yes, I do.
No, I do not.

ID & Banking Information

Copy of ID (e.g., Residence Card) *

Click or drag a file to this area to upload.

jpg or pdf

Bank *

Account Number *

Copy of Physical or Digital Bank Book *