English:
By agreeing to this consent form, I hereby grant my free, voluntary, and unconditional consent to the collection and processing of all my personal information (including sensitive personal information) disclosed by me in person to any authorized agent/s of DHVSU School of Law Legal Aid Clinic, by whatever means in accordance with the “Data Privacy Act of 2012” of the Republic of the Philippines or Republic Act 10173. I understand that any personal information collected from me will be for the use of the Clinical Legal Education Program of DHVSU School of Law.
Tagalog:
Sa pamamagitan ng pagsang-ayon sa kasulatang pahintulot na ito, ibinibigay ko ang aking libre, boluntaryo, at walang kundisyong pahintulot sa pangongolekta at pagproseso ng lahat ng aking personal na impormasyon (kabilang ang sensitibong personal na impormasyon) na isiniwalat ko nang personal sa sinumang awtorisadong ahente ng DHVSU School of Law Legal Aid Clinic, sa anumang paraan na alinsunod sa “Data Privacy Act of 2012” ng Republika ng Pilipinas o Republic Act No. 10173. Naintindihan ko na ang anumang personal na impormasyong makolekta mula sa akin ay para sa paggamit ng Clinical Legal Education Program ng DHVSU School of Law.