T-Hub T-Hub T-Hub T-Hub

t.Hub 共創空間進駐申請表

t.Hub Co-working Space Application Form

進駐類型  Applicant Type

名稱
Name

基本資料(三選一)  Basic Information(Choose one out of three)

企業負責人  Corporate representatives

姓名
Name

職稱
Job Title

連絡電話(室內)
Telephone No.

行動電話
Mobile No.

E-MAIL
E-mail Address

主要聯絡人  Primary contact

姓名
Name

職稱
Job Title

連絡電話(室內)
Telephone No.

行動電話
Mobile No.

E-MAIL
E-mail Address

預計進駐期程  Estimated Occupancy Period

共計
A Total of

個月
Month(s)

週
Week(s)

空間需求(可複選)  Space Requirements


 席Seat(s)

 席Seat(s)

 席Seat(s)


蒐集個人資料告知事項暨個人資料提供同意書


蒐集個人資料告知事項：
t.Hub管理單位(以下簡稱管理單位)為遵守個人資料保護法規定，在您提供個人資料予管理單位前，依法告知下列事項：
一、   管理單位因產業之輔導、教育或訓練行政、產學合作、政令宣導等等特定目的而獲取您下列個人資料類別：姓名及連絡方式(包括但不限於電話號碼、E-MAIL、居住或工作地址)等，或其他得以直接或間接識別您個人之資料。
二、 管理單位將依個人資料保護法及相關法令之規定下，依管理單位隱私權保護政策，蒐集、處理及利用您的個人資料。
三、 管理單位將於蒐集目的之存續期間合理利用您的個人資料。
四、 除蒐集之目的涉及國際業務或活動外，管理單位僅於中華民國領域內利用您的個人資料。
五、 管理單位將於原蒐集之特定目的、本案以外之產業之推廣、宣導及輔導、以及其他公務機關請求行政協助之目的範圍內，合理利用您的個人資料。
六、 您可依個人資料保護法第3條規定，就您的個人資料向管理單位行使下列權利：
(一)查詢或請求閱覽。
(二)請求製給複製本。
(三)請求補充或更正。
(四)請求停止蒐集、處理及利用。
(五)請求刪除。
您因行使上述權利而導致對您的權益產生減損時，管理單位不負相關賠償責任。另依個人資料保護法第14條規定，管理單位得酌收行政作業費用。
七、 若您未提供正確之個人資料，管理單位將無法為您提供特定目的之相關業務。
八、 管理單位因業務需要而委託其他機關處理您的個人資料時，將善盡監督之責。
九、 您瞭解此一同意書符合個人資料保護法及相關法規之要求，且同意管理單位留存此同意書，供日後取出查驗。

個人資料之同意提供：
一、 本人已充分知悉貴管理單位上述告知事項。
二、 本人同意貴管理單位蒐集、處理、利用本人之個人資料，以及其他公務機關請求行政協助目的之提供。



Notification of Personal Information Collection and Consent Form for Provision of Personal Information


Notice on collection of personal data:
t.Hub management unit (hereinafter referred to as the management unit), shall inform you of the following matters in accordance with the law, in order to comply with the provisions of the Personal Data Protection Law, before you provide your personal data to the management unit.
1.   The management unit obtains the following categories of personal data from you for specific purposes such as industry counseling, education or training administration, industry-university cooperation, government decree publicity, etc.; name and contact information (including but not limited to phone number, E-MAIL, residence, or work address), or any other information that can directly or indirectly identify you as an individual.
2. 2. The management unit will collect, process and use your personal data in accordance with the provisions of the Personal Data Protection Act and relevant laws and regulations, and in accordance with the privacy protection policy of the management unit.
3. The management unit will make reasonable use of your personal data during the duration of the collection purposes.
4. Except for the purpose of collection involving international business or activities, the management unit only uses your personal data within the territory of the Republic of China.
5. The management unit will make reasonable use of your personal data within the scope of the specific purpose of the original collection, promotion, publicity and guidance of industries other than this case, and the purpose of other government agencies requesting administrative assistance.
6. You may exercise the following rights to the management unit regarding your personal data
1. Inquiry or request for viewing.
2. Request to make copies.
3. Request for addition or correction.
4. Request to stop collecting, processing or utilizing.
5. Request to delete.
If your rights and interests are impaired due to the exercise of the above rights, the management unit shall not be liable for relevant compensation. In addition, in accordance with Article 14 of the Personal Data Protection Act, the management unit may collect administrative fees at its discretion.
7. If you do not provide correct personal information, the management unit will not be able to provide you with relevant services for specific purposes.
8. If it is necessary for the management unit to entrust other units to process your personal data due to business needs, the entrusted units will strictly comply with confidentiality obligations and take up the responsibility of supervision.
9. You understand that this consent form complies with the requirements of the Personal Data Protection Act and relevant regulations, and you agree to the maintenance agency to retain this consent form for future inspection.

Consent to provide personal data:
1. I am fully aware of the above notices from your management unit.
2. I agree to your management unit authorized to collect, process, and use my personal data, and to provide other government agencies for the purpose of requesting administrative assistance.