Data Access request Form

Website(*)

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Your Name(*)

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What email address do you use to access the above website / app?(*)

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You are submitting this request as

The person, or the parent / guardian of the person, whose name appears above.An agent authorized by the consumer to make this request on their behalf.

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Under the rights of which law are you making this request?(*)

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I am submitting a request to ________(*)

Please leave details regarding your action request or question.

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I confirm that(*)

Under penalty of perjury, I declare all the above information to be true and accurate.I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with My Great New Website / App.I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.

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