AIM Recruitment Privacy Form

Your consent to collection use and storage of your personal and sensitive information:

I ___________________________________(Full Name)

of ___________________________________(Address)

who can be identified by ___________________________________(Full Name)

Further means of identification ___________________________________

I have read and understood each of the statements in this Collection Statement and voluntarily consent to –

- Personal and sensitive information about me being collected by you as indicated above

- Personal and sensitive information about me being used as indicated above

- Personal and sensitive information about me being disclosed as indicated above

Date: ___________________________________

Signed: ___________________________________

Witness: ___________________________________

Print witness name: ___________________________________

Address of witness: ___________________________________