DATA RETENTION AGREEMENT

Irish Aid Fellowship Alumni Network

I agree that ICOS, on behalf of Irish Aid and the Department of Foreign Affairs and Trade, may retain
my data (as detailed below) for the purposes of including me in the Irish Aid Fellowship Alumni
Network, and for the purposes of maintaining a proper record of my achievements during my time as
an Irish Aid fellow. I understand that this information includes:

My name

My gender

My nationality (and the country from which I was issued a fellowship award, if different)

My contact information (email and mailing addresses)

The year of my fellowship award and completion of my studies

My institution(s) and course of study during the period of my fellowship

My employment details in my home country (if applicable)

The results of my course of studies

My postgraduate thesis title and abstract (if applicable)

Any other of my notable achievements during the period of my fellowship

Any photographs taken of me during the period of my fellowship

I agree that ICOS may retain all additional data provided by me during the course of my fellowship
until such time as I have received all of my graduation documents and/or until such time as ICOS no
longer deems it necessary to retain this data, up to a maximum period of two years following the
completion of my studies. I also understand that ICOS may from time to time, as necessary, share my
data with the Embassy of Ireland through which I was awarded an Irish Aid Fellowship, or with Irish
Aid, and that my image may be used in ICOS, Irish Aid and/or Irish Embassy publications. I
understand that ICOS will not share my data with any other third party.

Finally, I am aware that I may change my mind and request that ICOS remove my data from their
database at any time.
(Please print this form and hand sign below if you agree to the above)

Signature: ________________________________________ Date: _______________________

Printed Name (BLOCK CAPITALS): _____________________________________________________