2 minutes
Any individual who wants to avail the services of a company that collects, uses, or discloses personal data must fill out a data privacy consent form.
I consent to the collection of my personal data by the Data Controller for the purposes of:
I understand that the organization will be collecting, using, and disclosing my personal data for the following purposes: a. To provide me with products and/or services that I have requested; b. For marketing and promotional purposes; c. For the purposes of conducting market research and/or customer satisfaction surveys; d. To contact me in relation to matters pertaining to the products and/or services that I have requested; and e. For any other purpose which I may have consented to.
I have read and understood the Data Controller’s Privacy Policy. I understand that I may withdraw my consent at any time by contacting the Data Controller.
Name
Signature
Date
Address
Email address
I consent to the collection, use, and disclosure of my personal data by the organization.