Personal Information Rights Request Form You may have certain rights regarding your personal information. To exercise these rights, please complete all required fields below. The information you provide will help us verify your identity and respond to your request. Thank you! 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For information about our privacy practices, click here If the submit button is clicked, we will not take any further actions and any system notifications must be ignored.State(Required)Please make a selection...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPlease select the state where you liveThis feature is not available at this time for residents of the selected area. For information about our privacy practices, click here If the submit button is clicked, we will not take any further actions and any system notifications must be ignored.Select a request type(Required) Access my data Delete my data Do not sell my personal information Which would you like to receive?(Required) The categories of personal information we collected about you The specific pieces of data we collect about you Select AllOpt out of sale To opt-out of the sale of your personal information, please click the “Do Not Sell My Personal Information” link in the footer of our website. If the submit button is clicked, we will not take any further actions and any system notifications must be ignored. First Name(Required) Last Name(Required) Email(Required) Alternate Email If the email address provided above is different from the one linked to your account, please provide the email linked to your account:Postal Address Verification Information Please type in the boxes below all of the following: (1) the products purchased in your last transaction with AFYA, (2) the amount of your last transaction, and (3) the confirmation number of your last transaction. If you have never purchased anything from AFYA, please type “nothing” or “N/A”. Products purchased in your last transaction with AFYA(Required) The amount of your last transaction with AFYA:(Required) The confirmation number of your last transaction with AFYA:(Required) EmailThis field is for validation purposes and should be left unchanged.