Colorado Christian University - M.A. Clinical Mental Health Counseling

CCPA Privacy Rights Request Form

If you are a California State resident, you may be able to exercise certain data rights under the California Consumer Privacy Act (“CCPA”) or California’s “Shine the Light” lawby making the appropriate selection below. For additional discussion of your privacy rights, please visit our Privacy Policy by Clicking Here.

Please select one:

Data Deletion Request (where you want us to delete all information that we have collected about

Data Portability Request (where you want to know the specific information that we have collected about you)

Information Disclosure Request (where you want to know where we collected your information from, to which categories parties we shared it with, the associated business purposes for each and h and additional required disclosures)

First Name: *

Last Name: *

Phone Number: *

Email Address: *

Address: *

City: *

State: *

Zip Code: *

*Required fields

· Users with disabilities (and any other users) who wish to make a data deletion request, data portability request and/or information disclosure request can also contact us by emailing us at: admin@13thfloormedia.com; calling us at: 888-423-0213; or sending us U.S. mail to: 13thFloor Media LLC, 265 South Federal Hwy, Suite 237, Deerfield Beach FL 33441.

· Where you make a data deletion request, data portability request and/or information disclosure request through an authorized agent, we will require that you or the authorized agent provide us with a valid written authorization executed by both parties, with the validity of such document determined by us in our reasonable, good faith discretion. Please submit such documentation to us at: admin@13thfloormedia.com, or 13thFloor Media LLC, 265 South Federal Hwy, Suite 237, Deerfield Beach FL 33441.

· Making a verifiable consumer request does not require you to create an account with us. However, we do consider requests made through your password protected account sufficiently verified when the request relates to personal information associated with that account.

· We will only use personal information in a verifiable consumer request to verify the requestor's identity or authority to make the request.

· You may only make a verifiable consumer request for access or data portability twice within a twelve (12)-month period.