California Consumer Privacy Act (CCPA) Request Form

California residents may make requests for the personal information collected and held by International Schools Services (“ISS”) about them by submitting this request form to ISS Compliance by email at privacy@iss.edu.  Please select the type of request you wish to make and provide us information to aid us in verifying your identity.

1. Is your primary residence in the state of California?

☐ Yes
☐ No

2. I am a (an):

☐ Candidate
☐ Prospective Candidate
☐ ISS Employee
☐ Employee of an ISS Client
☐ Other:____________________

3. Your details:

a. First Name: ____________________
b. Last Name: ____________________
c. Email: ____________________
d. California Mailing Address: ____________________

4. Your request:

☐ Know the categories of personal information that ISS has collected, used, and or disclosed about you;
☐ Obtain the specific pieces of personal information that ISS collected about you;
☐ Delete the personal information that ISS has collected from you; or
☐ Do not sell the personal information that ISS has collected from you

5. Please explain your request:

 

By submitting this form, I hereby certify that the information entered into this form is complete, accurate, and up-to-date, and that I am the consumer who is the subject of the request or have been authorized by that consumer to act on his/her behalf, as indicated above. I understand that it may be necessary for ISS to verify the identity of the consumer and/or authorized agent for this request, and additional information may be requested for this purpose.

 

Signature: __________________________

Name [print]: _______________________

Date: __________________