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Data access request form - EURid
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href="/static/dist/keyboard/css/keyboard.e18a4fa42d0a.css"> <style> div#div_id_email label em { font-size: 12px; color: #7d7d7d; } label.form-checkbox { width: 100%; margin-bottom: 20px; } </style> </head> <body class="tpl-base lang-en site_ "> <a href="#main-content" aria-label="Skip to main content" class="sr-only sr-only-focusable" tabindex="0">Skip to main content</a> <div id="wrapper"><!--start wrapper--> <div class=" header_area"><!--start header_section--> <div class="top-whois-bar"> <form method="get" action="https://whois.eurid.eu/en/search/"> <label>WHOIS search</label> <input type="text" id="id_domain" name="domain" class="euridVirtualKeyboard" maxlength="253" value="" placeholder="" /> <i class="euridVirtualKeyboardIcon fa-regular fa-keyboard add-tooltip" style="cursor: pointer;"></i> <input type="submit" value="Search"> </form> </div> <nav class="navbar navbar-default navbar-static-top" role="navigation"> <div class="container-fluid"> <div class="row"> <div class="navbar-header col-sm-2"> <button type="button" class="navbar-toggle collapsed" data-toggle="collapse" data-target=".navbar-collapse"> <span class="sr-only">Toggle navigation</span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="icon-bar"></span> </button> <a class="navbar-brand pull-right" href="/"> <img src="/static/dist/images/logo_2018.b60061fd5b99.png" alt="" width="92" height="36"> </a> <a class="navbar-brand navbar-responsive pull-right" href="/"> <img src="/static/dist/images/logo_2018.b60061fd5b99.png" alt="" width="92" height="36"> </a> </div> <div class="col-sm-10 col-xs-12 navbar-collapse collapse"> <div class="col-sm-9 col-xs-12 navigation-top"> <ul class="nav navbar-nav"> <li class="child sibling" id="loop-language"> <div style="display: inline" class="text-right"> <div class="form-group select_title" style="display: inline-block"> <select class="selpicker language_picker" data-width="fit" data-live-search="false" data-mobile="true" data-role="button" data-aria-label="Select website language"> <option value="/bg/druga-informaciya/formulyar-za-iskane-na-dostp-do-lichni-danni/">斜褗谢谐邪褉褋泻懈 (bg) </option> <option value="/es/mas-informacion/formulario-de-solicitud-de-acceso-datos/">espa帽ol (es) </option> <option value="/cs/dalsi-informace/formular-pro-podani-pozadavku-na-pristup-k-udajum/">膷e拧tina (cs) </option> <option value="/da/anden-information/ansogningsform-adgang-til-data/">dansk (da) </option> <option value="/de/weitere-informationen/antrag-auf-datenzugriff/">Deutsch (de) </option> <option value="/et/muu-informatsioon/andmete-juurdepaasu-taotlusvorm/">eesti (et) </option> <option value="/el/alles-plhrofories/entypo-aithshs-prosbashs-dedomenwn/">蔚位位畏谓喂魏维 (el) </option> <option value="/en/other-infomation/data-access-request-form/" selected>English (en) </option> <option value="/fr/other-information/formulaire-de-demande-dacces-aux-donnees/">fran莽ais (fr) </option> <option value="/ga/eolas-eile/foirm-iarratais-um-rochtain-ar-shonrai/">Gaeilge (ga) </option> <option value="/hr/druge-informacije/obrazac-zahtjeva-za-pristup-podacima/">hrvatski (hr) </option> <option value="/it/altre-informazioni/modulo-di-richiesta-di-accesso-dati/">italiano (it) </option> <option value="/lv/cita-infromacija/datu-piekluves-pieprasijumu-veidlapa/">latvie拧u (lv) </option> <option value="/lt/kita-informacija/prasymas-susipazinti-su-duomenimis/">lietuvi懦 (lt) </option> <option value="/hu/other-information/adat-hozzaferesi-kerelem/">magyar (hu) </option> <option value="/mt/informazzjoni-ora/formola-g-talba-ta-ess-gad-data/">Malti (mt) </option> <option value="/nl/overige-informatie/aanvraagformulier-voor-toegang-tot-gegevens/">Nederlands (nl) </option> <option value="/pl/dalsze-informacje/wniosek-o-udostepnienie-danych-osobowych/">polski (pl) </option> <option value="/pt/outras-informacoes/formulario-de-pedido-de-acesso-dados/">portugu锚s (pt) </option> <option value="/ro/alte-informaii/formular-pentru-solicitarea-accesului-la-date/">rom芒n膬 (ro) </option> <option value="/sk/dalsie-informacie/ziadost-o-pristup-k-osobnym-udajom/">sloven膷ina (sk) </option> <option value="/sl/ostale-informacije/obrazec-zahtevka-za-dostop-do-podatkov/">sloven拧膷ina (sl) </option> <option value="/fi/lisaa-meista/tietojen-tarkastuspyyntolomake/">suomi (fi) </option> <option value="/sv/annan-information/utlamning-personuppgifter/">svenska (sv) </option> </select> </div> <span class="loop-link"> <a href="javascript:void(0);" id="search_menu" aria-label="Website search"><i class="fa-solid fa-magnifying-glass text-white"></i></a> </span> </div> </li> <li class="child dropdown children"> <a href="#" class="dropdown-toggle" data-toggle="dropdown"> <span class="mobile_tablet_view">Welcome to EURid</span> <span class="desktop_view" onclick="window.location.replace('/en/welcome-to-eurid/');">Welcome to EURid</span> <span class="caret menu-icon"></span> </a> <ul class="dropdown-menu"> <li class="child mobile_tablet_view"> <a href="/en/welcome-to-eurid/">Welcome to EURid</a> </li> <li class="child dropdown children"> <a href="#" class="collapsible-sub-menu dropdown-toggle" data-target-custom="#379_menu" data-toggle="dropdown"> <span class="menu-title mobile_tablet_view">About us</span><span onclick="window.location.replace('/en/welcome-to-eurid/about-us/');" class="menu-title desktop_view">About us</span> <i class="fa-solid fa-caret-right menu-icon"></i> </a> <ul class="submenu dropdown-menu" id="379_menu"> <li class="mobile_tablet_view child dropdown children"> <a href="/en/welcome-to-eurid/about-us/">About us</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/about-us/#nav_team">Vacancies</a> </li> </ul> </li> <li class="child"> <a href="/en/welcome-to-eurid/corporate-governance/">Corporate Governance</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/tech-excellence/">Tech excellence</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/cyber-security/">Cyber Security</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/going-green/">Going green</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/partnerships/">Partnerships</a> </li> <li class="child dropdown children"> <a href="#" class="collapsible-sub-menu dropdown-toggle" data-target-custom="#54_menu" data-toggle="dropdown"> <span class="menu-title mobile_tablet_view">Initiatives</span><span onclick="window.location.replace('/en/welcome-to-eurid/initiatives/');" class="menu-title desktop_view">Initiatives</span> <i class="fa-solid fa-caret-right menu-icon"></i> </a> <ul class="submenu dropdown-menu" id="54_menu"> <li class="mobile_tablet_view child dropdown children"> <a href="/en/welcome-to-eurid/initiatives/">Initiatives</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/initiatives/eu-academy/">.eu Academy</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/initiatives/the-eu-day/">The .eu day</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/initiatives/art-competition/">Art Competition</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/initiatives/eu-live-talks/">.eu Live Talks</a> </li> </ul> </li> <li class="child"> <a href="/en/welcome-to-eurid/publications/">Publications</a> </li> <li class="child"> <a href="/en/welcome-to-eurid/statistics/">Statistics</a> </li> </ul> </li> <li class="child"> <a href="/en/home/">News</a> </li> <li class="child dropdown children"> <a href="#" class="dropdown-toggle" data-toggle="dropdown"> <span class="mobile_tablet_view">Register a domain name</span> <span class="desktop_view" onclick="window.location.replace('/en/register-a-eu-domain/');">Register a domain name</span> <span class="caret menu-icon"></span> </a> <ul class="dropdown-menu"> <li class="child mobile_tablet_view"> <a href="/en/register-a-eu-domain/">Register a domain name</a> </li> <li class="child dropdown children"> <a href="#" class="collapsible-sub-menu dropdown-toggle" data-target-custom="#10_menu" data-toggle="dropdown"> <span class="menu-title mobile_tablet_view">Rules for domain names</span><span onclick="window.location.replace('/en/register-a-eu-domain/rules-for-eu-domains/');" class="menu-title desktop_view">Rules for domain names</span> <i class="fa-solid fa-caret-right menu-icon"></i> </a> <ul class="submenu dropdown-menu" id="10_menu"> <li class="mobile_tablet_view child dropdown children"> <a href="/en/register-a-eu-domain/rules-for-eu-domains/">Rules for domain names</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/rules-for-eu-domains/application-form-activation-reserved-name/">Application form for the activation of a reserved name</a> </li> </ul> </li> <li class="child"> <a href="/en/register-a-eu-domain/find-a-registrar/">Find a registrar</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/domain-names-with-special-characters-idns/">Domain names with special characters (IDNs)</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/data-quality/">Data Quality</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/domain-name-disputes/">Domain name disputes</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/guidelines-eu-cyrillic/">Guidelines for .eu in Cyrillic</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/guidelines-eu-greek/">Guidelines for .eu in Greek</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/gdpr/">GDPR</a> </li> <li class="child"> <a href="/en/register-a-eu-domain/brexit-notice/">Brexit notice</a> </li> </ul> </li> <li class="child"> <a href="/en/my-eu/">My .eu</a> </li> <li class="child dropdown children"> <a href="#" class="dropdown-toggle" data-toggle="dropdown"> <span class="mobile_tablet_view">Become a registrar</span> <span class="desktop_view" onclick="window.location.replace('/en/become-a-eu-registrar/');">Become a registrar</span> <span class="caret menu-icon"></span> </a> <ul class="dropdown-menu"> <li class="child mobile_tablet_view"> <a href="/en/become-a-eu-registrar/">Become a registrar</a> </li> <li class="child"> <a href="/en/become-a-eu-registrar/fees-and-payments/">Fees and payments</a> </li> <li class="child"> <a href="/en/become-a-eu-registrar/accreditation-criteria/"> Accreditation criteria</a> </li> </ul> </li> <li class="child whois_item"> <a href="javascript:void(0);">WHOIS</a> </li> </ul> </div> <div class="navbar-right col-sm-3 hidden-xs language-selector"> <div class="form-group select_title" style="display: inline-block"> <select class="selpicker language_picker" data-width="fit" data-live-search="false" data-mobile="true" data-role="button" data-aria-label="Select website language"> <option value="/bg/druga-informaciya/formulyar-za-iskane-na-dostp-do-lichni-danni/">斜褗谢谐邪褉褋泻懈 (bg) </option> <option value="/es/mas-informacion/formulario-de-solicitud-de-acceso-datos/">espa帽ol (es) </option> <option value="/cs/dalsi-informace/formular-pro-podani-pozadavku-na-pristup-k-udajum/">膷e拧tina (cs) </option> <option value="/da/anden-information/ansogningsform-adgang-til-data/">dansk (da) </option> <option value="/de/weitere-informationen/antrag-auf-datenzugriff/">Deutsch (de) </option> <option value="/et/muu-informatsioon/andmete-juurdepaasu-taotlusvorm/">eesti (et) </option> <option value="/el/alles-plhrofories/entypo-aithshs-prosbashs-dedomenwn/">蔚位位畏谓喂魏维 (el) </option> <option value="/en/other-infomation/data-access-request-form/" selected>English (en) </option> <option value="/fr/other-information/formulaire-de-demande-dacces-aux-donnees/">fran莽ais (fr) </option> <option value="/ga/eolas-eile/foirm-iarratais-um-rochtain-ar-shonrai/">Gaeilge (ga) </option> <option value="/hr/druge-informacije/obrazac-zahtjeva-za-pristup-podacima/">hrvatski (hr) </option> <option value="/it/altre-informazioni/modulo-di-richiesta-di-accesso-dati/">italiano (it) </option> <option value="/lv/cita-infromacija/datu-piekluves-pieprasijumu-veidlapa/">latvie拧u (lv) </option> <option value="/lt/kita-informacija/prasymas-susipazinti-su-duomenimis/">lietuvi懦 (lt) </option> <option value="/hu/other-information/adat-hozzaferesi-kerelem/">magyar (hu) </option> <option value="/mt/informazzjoni-ora/formola-g-talba-ta-ess-gad-data/">Malti (mt) </option> <option value="/nl/overige-informatie/aanvraagformulier-voor-toegang-tot-gegevens/">Nederlands (nl) </option> <option value="/pl/dalsze-informacje/wniosek-o-udostepnienie-danych-osobowych/">polski (pl) </option> <option value="/pt/outras-informacoes/formulario-de-pedido-de-acesso-dados/">portugu锚s (pt) </option> <option value="/ro/alte-informaii/formular-pentru-solicitarea-accesului-la-date/">rom芒n膬 (ro) </option> <option value="/sk/dalsie-informacie/ziadost-o-pristup-k-osobnym-udajom/">sloven膷ina (sk) </option> <option value="/sl/ostale-informacije/obrazec-zahtevka-za-dostop-do-podatkov/">sloven拧膷ina (sl) </option> <option value="/fi/lisaa-meista/tietojen-tarkastuspyyntolomake/">suomi (fi) </option> <option value="/sv/annan-information/utlamning-personuppgifter/">svenska (sv) </option> </select> </div> <span class="loop-link"> <a href="javascript:void(0);" id="search_menu" aria-label="Website search"><i class="fa-solid fa-magnifying-glass text-white"></i></a> </span> </div> </div> </div> </div> </nav><!-- /.navbar-default --> <div id="popup_content_area" role="dialog"> <button type="button" class="close_pop" aria-label="Close website search"></button> <div id="pop_search"> <form action="/en/search/" method="get"> <label for="id_q">Website search</label> <input type="text" id="id_q" name="q" autocomplete="off"/> <input type="submit" value="Search"/> </form> </div> </div> </div><!--//end #header_section--> <main class="main-content" id="main-content" role="main"> <div class="container-fluid"> <div class="row"> <div class="col-lg-12"> <div class="plain_text_content"> <div class="entry"> <h1 class="plain_text_title">Data access request form</h1> <ul class="nav nav-tabs"> <li class="active"><a data-toggle="tab" href="#dar_slider_303889_0" aria-expanded="true">Domain name holders</a></li> <li class=""><a data-toggle="tab" href="#dar_slider_303889_1" aria-expanded="false">Non domain name holders</a></li> </ul> <div class="tab-content"> <div class="tab-pane fade in active" id="dar_slider_303889_0"> <div class="alert-wrap in" id="form_alert_303890" style="display: none;"> <div class="alert" role="alert"> <div class="media"> <div class="media-body"> </div> </div> </div> </div> <div class="text-center" id="spinner_dar_303890" style="display: none;"> <i class="fa-solid fa-spinner fa-spin fa-2x"></i> </div> <p><i>Please note that this form is not applicable to you if you are no longer the holder of a domain name registered under .eu or its variants in other scripts.</i></p> <p>Please read our <a href="https://eurid.eu/en/other-infomation/privacy-policy/">Privacy Policy</a> carefully before completing and submitting this form.</p> <p>By clicking the 'submit' button below, you exercise your right to gain access to your personal data as described in our <a href="https://eurid.eu/en/other-infomation/privacy-policy/">Privacy Policy</a>. The completed form will be submitted to EURid vzw, Telecomlaan 9, 1831<font color="#323232" face="Open Sans"><span style="font-size: 18px;"><i> </i></span></font>Diegem, Belgium.</p> <p>Please note that we can only handle your request if we have sufficient evidence regarding your identity.</p> <p>Once we have received your completed form, we will respond to you within 30 days.</p> <form class="form-confirm parsley" method="post" action="/en/dar/dar/submit/" id="form_dar_303890" disabled> <div class="row"> <div class="col-xs-12"> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_domain_eurid_has_data" class="control-group "> <input type="checkbox" name="domain_eurid_has_data" class="magic-checkbox" id="id_domain_eurid_has_data"> <label for="id_domain_eurid_has_data" class=" "> <span>I want to know what personal data EURid processes about me.</span> </label> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_domain_receive_copy" class="control-group "> <input type="checkbox" name="domain_receive_copy" class="magic-checkbox" id="id_domain_receive_copy"> <label for="id_domain_receive_copy" class=" "> <span>I want to receive a copy of my personal data.</span> </label> <span class="errors"></span> </div> </div> </div> </div> <div class="row row-eq-height" style="align-items: flex-end"> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_email_domain" class="control-group "> <label for="id_email_domain" class="required-field"> Email <span>*</span> <br> <small><em>We will only communicate with you through the email address related to your domain name(s) as shown in WHOIS, therefore this email address must match the email address you provided when registering your domain name(s)</em></small> </label> <input type="email" name="email" maxlength="100" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="100" data-parsley-type="email" id="id_email_domain" class="form-control" required> <span class="errors"></span> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_first_name" class="control-group "> <label for="id_first_name" class="required-field" > First name <span>*</span> </label> <input type="text" name="first_name" maxlength="250" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="250" class="form-control" required id="id_first_name"> <span class="errors"></span> </div> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_last_name" class="control-group "> <label for="id_last_name" class="required-field" > Last name <span>*</span> </label> <input type="text" name="last_name" maxlength="250" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="250" class="form-control" id_last_name_domain required id="id_last_name"> <span class="errors"></span> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_phone" class="control-group "> <label for="id_phone" class="required-field" > Phone <span>*</span> </label> <input type="text" name="phone" maxlength="50" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="50" class="form-control" id_phone_domain required id="id_phone"> <span class="errors"></span> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_language" class="control-group "> <label for="id_language" class="required-field" > Language <span>*</span> </label> <select name="language" data-parsley-required="true" data-parsley-required-message="This field is required." class="selpicker form-control" id_language_domain id="id_language"> <option value="bg">斜褗谢谐邪褉褋泻懈 (bg)</option> <option value="es">espa帽ol (es)</option> <option value="cs">膷e拧tina (cs)</option> <option value="da">dansk (da)</option> <option value="de">Deutsch (de)</option> <option value="et">eesti (et)</option> <option value="el">蔚位位畏谓喂魏维 (el)</option> <option value="en" selected>English (en)</option> <option value="fr">fran莽ais (fr)</option> <option value="ga">Gaeilge (ga)</option> <option value="hr">hrvatski (hr)</option> <option value="it">italiano (it)</option> <option value="lv">latvie拧u (lv)</option> <option value="lt">lietuvi懦 (lt)</option> <option value="hu">magyar (hu)</option> <option value="mt">Malti (mt)</option> <option value="nl">Nederlands (nl)</option> <option value="pl">polski (pl)</option> <option value="pt">portugu锚s (pt)</option> <option value="ro">rom芒n膬 (ro)</option> <option value="sk">sloven膷ina (sk)</option> <option value="sl">sloven拧膷ina (sl)</option> <option value="fi">suomi (fi)</option> <option value="sv">svenska (sv)</option> </select> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_address" class="control-group "> <label for="id_address" class="required-field" > Address <span>*</span> </label> <textarea name="address" cols="40" rows="2" maxlength="300" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="300" class="form-control" id_address_domain required id="id_address"> </textarea> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_domain_name" class="control-group "> <label for="id_domain_name" class="required-field" > .eu, .械褞 or .蔚蠀 domain name(s) <span>*</span> </label> <input type="text" name="domain_name" maxlength="500" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="500" class="form-control" required id="id_domain_name"> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <p><strong><u>DECLARATION</u></strong></p> <p><em>By clicking the 'submit' button below, I confirm that I am the person named herein and that I am submitting this form in relation to my own personal data. I confirm that all information provided herein is true, accurate and complete. I understand that the information that I have provided may be used by EURid to verify my identity and help locate the information to which my request relates. </em></p> <div class="form-group"> <div id="div_id_domain_confirm" class="control-group "> <input type="checkbox" name="domain_confirm" data-parsley-required="true" data-parsley-required-message="This field is required." class="magic-checkbox" required id="id_domain_confirm"> <label for="id_domain_confirm" class="required-field "> <span><em>I hereby acknowledge that I have read, understand, and consent to EURid's Privacy Policy.</em></span> </label> <span class="errors"></span> </div> </div> </div> <div class="row"> <div class="col-xs-12 text-left mar-btm"> <input type="hidden" name="gdprform_inst" value="303890"> <input type="hidden" name="type" value="domain"> <button type="submit" class="btn btn-primary btn-eurid btn-eurid-lg btn-lg">Submit</button> <div class="custom-csrf-token"></div> </div> </div> </form> </div> <div class="tab-pane fade " id="dar_slider_303889_1"> <div class="alert-wrap in" id="form_alert_303891" style="display: none;"> <div class="alert" role="alert"> <div class="media"> <div class="media-body"> </div> </div> </div> </div> <div class="text-center" id="spinner_dar_303891" style="display: none;"> <i class="fa-solid fa-spinner fa-spin fa-2x"></i> </div> <p><i>Please note that this form is not applicable to you if you are currently the </i><i>holder of a聽domain name registered under .eu or its variants in other scripts.</i></p> <p>Please read our <a href="https://eurid.eu/en/other-infomation/privacy-policy/">Privacy Policy</a> carefully before completing and submitting this form.</p> <p>By clicking the 'submit' button below, you exercise your right to gain access to your personal data as described in our <a href="https://eurid.eu/en/other-infomation/privacy-policy/">Privacy Policy</a>. The completed form will be submitted to EURid vzw, Telecomlaan 9, 1831<font color="#323232"><font face="Open Sans"><span style="font-size: 18px;"><i> </i></span></font></font>Diegem, Belgium.</p> <p>Please note that we can only handle your request if we have sufficient evidence regarding your identity.</p> <p>Once we have received your completed form, we will respond to you within 30 days.</p> <form class="form-confirm parsley" method="post" action="/en/dar/dar/submit/" id="form_dar_303891" disabled> <div class="row"> <div class="col-xs-12"> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_non_domain_eurid_has_data" class="control-group "> <input type="checkbox" name="non_domain_eurid_has_data" class="magic-checkbox" id="id_non_domain_eurid_has_data"> <label for="id_non_domain_eurid_has_data" class=" "> <span>I want to know what personal data EURid processes about me.</span> </label> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_non_domain_receive_copy" class="control-group "> <input type="checkbox" name="non_domain_receive_copy" class="magic-checkbox" id="id_non_domain_receive_copy"> <label for="id_non_domain_receive_copy" class=" "> <span>I want to receive a copy of my personal data.</span> </label> <span class="errors"></span> </div> </div> </div> </div> <div class="row row-eq-height" style="align-items: flex-end"> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_email" class="control-group "> <label for="id_email" class="required-field" > Email <span>*</span> </label> <input type="email" name="email" maxlength="100" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="100" data-parsley-type="email" class="form-control" id="id_email_no_domain" required> <span class="errors"></span> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_first_name" class="control-group "> <label for="id_first_name" class="required-field" > First name <span>*</span> </label> <input type="text" name="first_name" maxlength="250" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="250" class="form-control" required id="id_first_name"> <span class="errors"></span> </div> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_last_name" class="control-group "> <label for="id_last_name" class="required-field" > Last name <span>*</span> </label> <input type="text" name="last_name" maxlength="250" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="250" class="form-control" id_last_name_no_domain required id="id_last_name"> <span class="errors"></span> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_phone" class="control-group "> <label for="id_phone" class="required-field" > Phone <span>*</span> </label> <input type="text" name="phone" maxlength="50" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="50" class="form-control" id_phone_no_domain required id="id_phone"> <span class="errors"></span> </div> </div> </div> <div class="col-sm-6 col-xs-12"> <div class="form-group"> <div id="div_id_language" class="control-group "> <label for="id_language" class="required-field" > Language <span>*</span> </label> <select name="language" data-parsley-required="true" data-parsley-required-message="This field is required." class="selpicker form-control" id_language_no_domain id="id_language"> <option value="bg">斜褗谢谐邪褉褋泻懈 (bg)</option> <option value="es">espa帽ol (es)</option> <option value="cs">膷e拧tina (cs)</option> <option value="da">dansk (da)</option> <option value="de">Deutsch (de)</option> <option value="et">eesti (et)</option> <option value="el">蔚位位畏谓喂魏维 (el)</option> <option value="en" selected>English (en)</option> <option value="fr">fran莽ais (fr)</option> <option value="ga">Gaeilge (ga)</option> <option value="hr">hrvatski (hr)</option> <option value="it">italiano (it)</option> <option value="lv">latvie拧u (lv)</option> <option value="lt">lietuvi懦 (lt)</option> <option value="hu">magyar (hu)</option> <option value="mt">Malti (mt)</option> <option value="nl">Nederlands (nl)</option> <option value="pl">polski (pl)</option> <option value="pt">portugu锚s (pt)</option> <option value="ro">rom芒n膬 (ro)</option> <option value="sk">sloven膷ina (sk)</option> <option value="sl">sloven拧膷ina (sl)</option> <option value="fi">suomi (fi)</option> <option value="sv">svenska (sv)</option> </select> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_address" class="control-group "> <label for="id_address" class="required-field" > Address <span>*</span> </label> <textarea name="address" cols="40" rows="2" maxlength="300" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="300" class="form-control" id_address_no_domain required id="id_address"> </textarea> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <div class="form-group"> <div id="div_id_way_contact" class="control-group "> <label for="id_way_contact" class="required-field" > In what way(s) have you been in contact with us in the past ? <span>*</span> </label> <textarea name="way_contact" cols="40" rows="10" maxlength="1000" data-parsley-required="true" data-parsley-required-message="This field is required." data-parsley-maxlength="1000" class="form-control" required id="id_way_contact"> </textarea> <span class="errors"></span> </div> </div> </div> <div class="col-xs-12"> <p>In order to assess your identity and to prevent unauthorised disclosure of your personal data, we may request proof of your identity.</p> <p><strong><u>DECLARATION</u></strong></p> <p><em>By clicking the 'submit' button below, I confirm that I am the person named herein and that I am submitting this form in relation to my own personal data. I confirm that all information provided herein is true, accurate and complete. I understand that the information that I have provided may be used by EURid to verify my identity and help locate the information to which my request relates. </em></p> <div class="form-group"> <div id="div_id_non_domain_confirm" class="control-group "> <input type="checkbox" name="non_domain_confirm" data-parsley-required="true" data-parsley-required-message="This field is required." class="magic-checkbox" required id="id_non_domain_confirm"> <label for="id_non_domain_confirm" class="required-field "> <span><em>I hereby acknowledge that I have read, understand, and consent to EURid's Privacy Policy.</em></span> </label> <span class="errors"></span> </div> </div> </div> <div class="row"> <div class="col-xs-12 text-left mar-btm"> <input type="hidden" name="gdprform_inst" value="303891"> <input type="hidden" name="type" value="not_domain"> <button type="submit" class="btn btn-primary btn-eurid btn-eurid-lg btn-lg">Submit</button> <div class="custom-csrf-token"></div> </div> </div> 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