October 9, 2019

Dear Parent or Guardian

RE: Parent/Guardian Consent for Cisco Networking Academy Course

We are writing to you regarding Cisco Networking Academy Courses (the “Course”), which are
educational courses offered by our institution covering computer, networking and security skills.
Materials and resources for the course are provided by the Cisco Networking Academy online platform,
which supports education worldwide by teaching IT skills to young people to help enable them to innovate
like technologists, think like entrepreneurs, and act as social change agents solving today’s problems using
technology.

In light of recent changes to EU law, before any minor child may register for the Course, we must first
obtain an appropriate parent or guardian consent to such participation and the related collection and use of
personal information about the child. This letter is to provide you with information about how our
institution and Cisco will process the personal information of students in connection with the Course and
Cisco Networking Academy, and to obtain your consent to the collection, storage, processing and transfer
of your child’s personal information for such purposes.

As part of the administration and delivery of the Course, our institution and/or Cisco will collect name,
screen name, email address, birthdate, language, time zone, state and country – for the purposes of
administering and managing the Course, alumni access to curriculum and for providing program support
as needed. As Cisco is a global organization, all information processed by Cisco Networking Academy
may be transferred to Cisco in the United States or other Cisco affiliates worldwide.

In all cases, Cisco’s collection and use of personal information will be in accordance with Cisco’s Online
Privacy Statement, available at https://www.cisco.com/c/en/us/about/legal/privacy-full.html. More
detailed information about Cisco’s processing of personal data in connection with Cisco Networking
Academy can be found on NetAcad.com or by sending a request to us at umboh@smktibulukumba.sch.id

Request: If you agree to our institution’s and Cisco’s processing of your child’s personal information in
connection with the administration of the Course and use of the online Cisco Networking Academy
platform, please complete and sign below – and return a copy of this letter to
umboh@smktibulukumba.sch.id , no later than November 9, 2019 Please understand that minor students
are not eligible to register for or participate in the Course until this permission form is returned.

If you have any questions or would like to discuss further, please contact me at
umboh@smktibulukumba.sch.id. We look forward to your child’s participation in the Course, and to
helping enable the next generation of technologists!

Sincerely,

HARLY UMBOH, S.Pd

 Parent or Guardian Consent

I am the parent or guardian of the minor child named below, and consent to the collection and use of my
child’s personal information in connection with the administration of the Course and the Cisco
Networking Academy, as mentioned above as well at https://www.cisco.com/c/en/us/about/legal/privacy-
full.html and as included in the attached Cisco Networking Academy Privacy Data sheet. I understand
that I may withdraw this consent at any time by emailing umboh@smktibulukumba.sch.id

Student Name (Print): _______________________________________________

Parent/Guardian Name (Print): _________________________________________

Parent/Guardian Signature: ___________________________________________

Date: _______________________