TO BE COMPLETED BY ALL VISITORS TO BAS STATIONS OR RESEARCH SHIPS

VISITING SHIP  	     	CRUISE NUMBER	     	
OR				
VISITING BASE	     	PROJECT NAME  	     	

BAS POINT OF CONTACT	     	

PERSONAL DETAILS

SURNAME	     	
FIRST NAME 	     	
M/F & Title	             	

PERMANENT 	     	
  HOME	     	
  ADDRESS	     	

Telephone No (home)	     	(mobile)	     	
		(work)	     	
e-mail        (personal)	     	(work)	          	
Date of birth	     	Place of birth (Town & Country)	     	
Nationality	     	NI number (UK residents only)	     	
Passport number	     	Place of issue	     	
Date of issue	     	Date of expiry	     	
Special diet	     			
Blood group (if known)	     	

NEXT OF KIN
NAME  (IN FULL)	     	Title	     	
Relationship	     			
ADDRESS	     	
  (if different 	     	
  from above)	     	
Tel no - home	     	daytime (if different)	     	
Email	     	

SECOND CONTACT – FOR THOSE TRAVELLING TO THE ANTARCTIC
(while you are south bas will only support 2 contacts, but you may receive and send mail to as many people as you wish bearing in mind the cost to you if you go over your allowance)

NAME  (IN FULL)	     	Title	     	
Relationship	     			
ADDRESS	     	
  (if different 	     	
  from above)	     	
Tel no - home	     	daytime (if different)	     	
Email	     	
					
ACKNOWLEDGEMENT FORM

It is a condition of your visit that you acknowledge and agree to the following.

I confirm that I have read, understand, accept and will comply with:

•	Visitors’ Guidelines
•	BAS Policy on Alcohol and Drugs
•	Respect at Work – Bullying and Harassment
•	Medical Insurance Cover for Non BAS Staff

NAME	     	
DATE	     	

TO:	Operations Delivery Support Team
British Antarctic Survey
High Cross, Madingley Road
Cambridge CB3 0ET

Phone: 01223 221 458
Fax:      01223 362 616
email:   hathgo@bas.ac.uk 

How we use your personal data
BAS, as part of NERC, collects and maintains personal information so that it can arrange travel to the Antarctic.  All personal data is managed in accordance with the Data Protection principles set out in the Data Protection Act 1988.  Personal information for staff and Antarctic visitors will be available to the Operations and Logistics (OPAL) Support team and may be shared with customs and immigration; handling agents; air travel operators; and travel agents for the purpose of arranging travel.   All information will be kept for as long as there is a business need.  Regular visiting scientists’ personal data may be retained after their first trip in the expectation that it will be required in the future.  
For further information on how your information is used, how we maintain the security of your information, and your rights to access information we hold on you, please contact data.protection@nerc.ac.uk