Please put priority preferred Month April( ) July( ) November( ) Anymonth

(1)

[Attachment 2]

THE MINISTRY OF PATRIOTS AND VETERANS AFFAIRS

& THE KOREAN VETERANS ASSOCIATION THE REPUBLIC OF KOREA

AGREEMENT

We the undersigned, by accepting the invitation of the Ministry of Patriots and Veterans Affairs (MPVA) in Korea to participate in the 2016 Revisit Korea Program, agree to the following conditions;

The MPVA shall not become liable or responsible in any way in connection with such means of transport or other services, or for any loss, injury or damage to or in respect of any persons or property howsoever arising, nor be responsible for damages arising from the default of a tour operator/carrier, lost/damaged baggage, trip cancellation, bad weather, natural disaster or other acts of God.

Veteran(Bereaved Family)

Name ――――――――――――――Signature ――――――――Date――――--

Veteran(Bereaved Family) Companion

Name ――――――――――――――Signature ――――――――Date――――--

Please put priority preferred Month

April( ) July( ) November( )

Anymonth

(2)

[Attachment 3]

Participant Roster

Relationship Full Name Date of Birth Phone Number

Email Address.

Address:

Passport Number Expiration date

Contact Information

Name Relationship

Email Phone No.

Flight Info. No: Arrival: Departure

Service Period Branch/ Unit

Service

Number Rank Major

Battle Peace Ambassador Medal(Awarded before?) Please circle one Yes, No Medical Alert Information:

Blood Type:

Condition Medication and Instruction

--- ---\

Please attach a copy of all medications (in case of health emergency or hospitalization) Doctor’s Information:

Full Name: Contact Information:

Was Doctor’s approval granted for travel? (please circle one) Yes No

Please attach Doctor’s letter of instructions in case of hospitalization or emergency Medical Insurance Information (please attach a copy)

Insurance Company or Policy name:

Contact Information:

Policy Number:

Dietary or Physical Restrictions:

Dietary Restrictions:

Physical Restrictions:

Wheelchair requirement: Yes No

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[Attachment 4]

Confidentiality Agreement

1. Collection and Use of Confidential Information [Personal Information Collected]

For the purpose of managing veterans who join Revisit Korea Program, the MPVA collects personal information as follows:name, date of birth, address, contact, passport number, military unit and rank, picture, and health condition

[Uses of Personal Information]

The MPVA uses the information you provided for:

○ Programs

- Revisit Korea Program schedule coordination and veterans' health condition check - other programs carried out to honor veterans' sacrifices and dedication

○ Registration and Management of Veterans

[Retention Period of Personal Information]

○ All documents containing personal information are destroyed as soon as it is reasonable to assume that the purpose for which personal information was collected is no longer being served by retention of the personal information, except such personal information as follows:

- name, date of birth, address, - retention period : permanent

- purpose : to exclude veterans who have already participated in a Revisit Korea Program from the list of invitees for the next program

[Right to Refuse to Consent to the Agreement]

If you do not want to provide your personal information, MPVA will not collect it.

However, if you do not agree to this agreement, you cannot join the program.

Do you agree to above terms and conditions?□ Yes□ No

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2. Consent for the Processing of Sensitive Personal Data

The MPVA processes sensitive personal data(health condition including disease and medicine) for the purpose as follows:

- to check veterans' health

All confidential information you provided is used for only purposes for which it was collected, and will not be used for other purposes without your prior consent.

3. Consent for Processing of Personal Identity Information

The MPVA collects personal identity information(passport number) for the purpose ofusing it for Revisit Korea Program-related services as follows:

- flight ticket reservation - hotel reservation

4. Consent for Sharing Personal Information with the Third Parties

The MPVA shares personal information you provided with the contracted travel agency and hotel assisting the Revisit Korea Program team in managing veterans during their visit.

1. Third parties: travel agency and hotel

2. Shared information : name, passport number, contact information 3. Purpose : management of visiting veterans

4. Retention period of shared personal information: only during the visit of veterans (After the program, all documents containing personal information will be destroyed.)